Heart stress based on NT-proBNP changes may improve CVD risk stratification

For community-dwelling older adults, longitudinal changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations (heart stress [HS]) may improve risk stratification for cardiovascular disease (CVD) and mortality, according to a study published online Aug. 18 in the Annals of Internal Medicine.

Anping Cai, M.D., Ph.D., from Southern Medical University in Guangzhou, China, and colleagues examined the association of HS status, based on three-year changes in NT-proBNP concentrations, with the risk of total CVD and all-cause mortality in community-dwelling older adults free of prior CVD. Participants included 8,454 individuals without prior CVD who had NT-proBNP measured at trial enrollment and year 3. HS status was classified as persistently HS-free, HS remission, incident HS or sustained HS.

The researchers identified 818 CVD events and 1,584 deaths during a median follow-up of 8.0 years. Compared with the persistently HS-free category, the adjusted absolute risks (ARs) for total CVD at year 8 increased by 7.4% and 6.7% for incident HS and sustained HS, respectively. For all-cause mortality, adjusted ARs also increased by 6.1% and 7.5% for incident HS and sustained HS, respectively. Similar adjusted ARs were seen for the HS remission category and the persistently HS-free group.

“Future studies should determine whether HS status based on serial values of NT-proBNP can inform care to reduce CVD and mortality risk in an older adult population,” the authors write.

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