Department of Cardiology, Thoraxcenter, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, the Netherlands.
Eur Heart J. 2010 Jan;31(1):120-7. doi: 10.1093/eurheartj/ehp420. Epub 2009 Oct 23.
Natriuretic peptides including N-terminal pro-B-type natriuretic peptide (NT-proBNP) are established biomarkers in heart failure. However, their prognostic value in the general population is less well established. The purpose of our study was to investigate the prognostic properties of NT-proBNP for death and cardiovascular (CV) events in the general population.
In the population-based Prevention of Renal and Vascular End-stage Disease (PREVEND) study, 8383 subjects were prospectively followed for a median period of 7.5 years. There were 4181 (49.9%) males and 4202 (50.1%) females, mean age was 49.3 +/- 12.7 years (range 28-75). Median NT-proBNP at baseline was 37.7 pg/mL (IQR 16.8-73.8). All-cause death occurred in 437 (5.2%) subjects and there were 557 (6.6%) CV events. Higher levels of plasma NT-proBNP were related to higher event rates. When adjusted for age, gender, and other relevant covariates, each doubling of NT-proBNP remained significantly associated with a 22% increased risk for all-cause mortality (P < 0.001) and a 16% increased risk of CV events (P < 0.001).
In this large community-based cohort, plasma NT-proBNP was a strong predictor of death and a wide range of CV events.
利钠肽包括 N 端脑利钠肽前体（NT-proBNP）是心力衰竭的既定生物标志物。然而，它们在普通人群中的预后价值尚未得到充分证实。我们研究的目的是探讨 NT-proBNP 对普通人群死亡和心血管（CV）事件的预后价值。
在基于人群的预防肾脏和血管终末期疾病（PREVEND）研究中，8383 名受试者前瞻性随访中位数为 7.5 年。其中 4181 名（49.9%）为男性，4202 名（50.1%）为女性，平均年龄为 49.3 +/- 12.7 岁（范围 28-75）。基线时 NT-proBNP 的中位数为 37.7 pg/mL（IQR 16.8-73.8）。共有 437 名（5.2%）受试者发生全因死亡，557 名（6.6%）发生 CV 事件。血浆 NT-proBNP 水平越高，事件发生率越高。调整年龄、性别和其他相关协变量后，NT-proBNP 每增加一倍，全因死亡率的风险增加 22%（P < 0.001），CV 事件的风险增加 16%（P < 0.001）。
在这项大型基于社区的队列研究中，血浆 NT-proBNP 是死亡和广泛 CV 事件的强有力预测因子。
