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N-terminal pro-B-type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure
Tromp, Jasper Richards, Arthur Mark Tay, Wan Ting Teng, Tiew-Hwa Katherine Yeo, Poh Shuan Daniel Sim, David Jaufeerally, Fazlur Leong, Gerard Ong, Hean Yee Ling, Lieng Hsi
Tromp, Jasper
Richards, Arthur Mark
Tay, Wan Ting
Teng, Tiew-Hwa Katherine
Yeo, Poh Shuan Daniel
Sim, David
Jaufeerally, Fazlur
Leong, Gerard
Ong, Hean Yee
Ling, Lieng Hsi
Abstract
Aims
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is the most frequently used biomarker in heart failure (HF), but its prognostic utility across ethnicities is unclear.
Methods and results
This study included 546 Caucasians with HF from the Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure and 578 Asians with HF from the Singapore Heart Failure Outcomes and Phenotypes study. NT-proBNP was measured at discharge after HF hospitalization. The studied outcome was a composite of all-cause mortality and HF hospitalization at 18 months. Compared with Caucasian patients, Asian patients were younger (63 ± 12 vs. 71 ± 11 years); less often female (26% vs. 39%); and had lower body mass index (26 vs. 27 kg/m2), better renal function (61 ± 37 vs. 54 ± 20 mL/min/1.73 m2), lower rates of atrial fibrillation (25% vs. 46%), strikingly higher rates of diabetes (59% vs. 30%), and higher rates of hypertension (76% vs. 44%). Despite these clear inter-group differences in individual drivers of NT-proBNP, average levels were similar in Asians [2709 (1350, 6302) pg/mL] and Caucasians [2545 (1308, 5484) pg/mL] (P = 0.514). NT-proBNP was strongly associated with outcome [hazard ratio 1.28 (per doubling), 95% confidence interval 1.18–1.39, P < 0.001], regardless of ethnicity (Pinteraction = 0.719). NT-proBNP was similarly associated with outcome in HF with reduced and preserved ejection fraction in Asian (Pinteraction = 0.776) and Caucasian patients (Pinteraction = 0.558).
Conclusions
NT-proBNP has similar prognostic performance in Asians and Caucasians with HF despite ethnic differences in known clinical determinants of plasma NT-proBNP.
Keywords
Ethnicity, Heart failure, Prognosis, NT-proBNP, HFpEF
Date
2018
Type
Journal article
Journal
ESC Heart Failure
Book
Volume
5
Issue
2
Page Range
279-287
Article Number
ACU Department
School of Theology
Faculty of Theology and Philosophy
Faculty of Health Sciences
Faculty of Theology and Philosophy
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled