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European Heart Journal Advance Access published online on October 23, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp420
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

N-terminal pro-B-type natriuretic peptide is an independent predictor of cardiovascular morbidity and mortality in the general population

Gerard C.M. Linssen1, Stephan J.L. Bakker2, Adriaan A. Voors1,*, Ron T. Gansevoort3, Hans L. Hillege1, Paul E. de Jong3, Dirk J. van Veldhuisen1, Rijk O.B. Gans2 and Dick de Zeeuw4

1 Department of Cardiology, Thoraxcenter, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, the Netherlands
2 Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands
3 Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, Groningen, the Netherlands
4 Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

Received 5 October 2008; revised 19 June 2009; accepted 20 August 2009 * Corresponding author. Tel: +31 50 3613874, Fax: +31 50 3614391, Email: a.a.voors{at}thorax.umcg.nl

Aims: 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.

Methods and results: 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).

Conclusion: In this large community-based cohort, plasma NT-proBNP was a strong predictor of death and a wide range of CV events.

Key Words: Cardiovascular diseases • Epidemiology • Natriuretic peptides • Population • Prognosis


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