TY - JOUR
T1 - N-terminal pro-B-type natriuretic peptide is not a significant predictor of stroke incidence after 5 years ― The Ohasama study ―
AU - Satoh, Michihiro
AU - Murakami, Takahisa
AU - Asayama, Kei
AU - Hirose, Takuo
AU - Kikuya, Masahiro
AU - Inoue, Ryusuke
AU - Tsubota-Utsugi, Megumi
AU - Murakami, Keiko
AU - Matsuda, Ayako
AU - Hara, Azusa
AU - Obara, Taku
AU - Kawasaki, Ryo
AU - Nomura, Kyoko
AU - Metoki, Hirohito
AU - Node, Koichi
AU - Imai, Yutaka
AU - Ohkubo, Takayoshi
N1 - Funding Information:
We are grateful to the residents and staff members in Ohasama and staff members of the Hanamaki City Government, Ohasama Hospital, Iwate Prefectural Stroke Registry, General Hanamaki Hospital, Teikyo University, Tohoku Medical and Pharmaceutical University, and Tohoku University for their valuable support on the Ohasama study project. This study was supported by Grants for Scientific Research (16H05243, 16H05263, 16K09472, 16K11850, 16K15359, 17H04126, 17H06533, 17K15853, 17K19930, 18K09674, 18K09904, and 18K17396), Culture, Sports, Science, and Technology, Japan; Grant-in-Aid for Young Scientists of Showa Pharmaceutical University H28-4; the Japan Arteriosclerosis Prevention Fund; Comprehensive Research on Cardiovascular and Life-Style Related Diseases (H26-Junkankitou [Seisaku]-Ippan-001) and (H29-Junkankitou-Ippan-003) from the Ministry of Health, Labor, and Welfare; and A Scheme to Revitalize Agriculture and Fisheries in Disaster Area through Deploying Highly Advanced Technology (NouEi 2-02) from the Ministry of Agriculture, Forestry and Fisheries, Japan; academic contributions from Pfizer Japan Inc.; and scholarship donations from Chugai Pharmaceutical Co., Ltd. and Daiichi Sankyo Co., Ltd.
Funding Information:
This study was supported by Grants for Scientific Research (16H05243, 16H05263, 16K09472, 16K11850, 16K15359, 17H04126, 17H06533, 17K15853, 17K19930, 18K09674, 18K09904, and 18K17396), Culture, Sports, Science, and Technology, Japan; Grant-in-Aid for Young Scientists of Showa Pharmaceutical University H28-4; the Japan Arteriosclerosis Prevention Fund; Comprehensive Research on Cardiovascular and Life-Style Related Diseases (H26-Junkankitou [Seisaku]-Ippan-001) and (H29-Junkankitou-Ippan-003) from the Ministry of Health, Labor, and Welfare; and A Scheme to Revitalize Agriculture and Fisheries in Disaster Area through Deploying Highly Advanced Technology (NouEi 2-02) from the Ministry of Agriculture, Forestry and Fisheries, Japan; academic contributions from Pfizer Japan Inc.; and scholarship donations from Chugai Pharmaceutical Co., Ltd. and Daiichi Sankyo Co., Ltd.
Publisher Copyright:
© 2018, Japanese Circulation Society. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point. Methods and Results: We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. Conclusions: NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.
AB - Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point. Methods and Results: We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. Conclusions: NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.
KW - Epidemiology
KW - N-terminal pro-B-type natriuretic peptide
KW - Prevention
KW - Stroke
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U2 - 10.1253/circj.CJ-17-1227
DO - 10.1253/circj.CJ-17-1227
M3 - Article
C2 - 29887544
AN - SCOPUS:85050585012
VL - 82
SP - 2055
EP - 2062
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 8
ER -