title: Association between anaemia and N-terminal pro-B-type natriuretic peptide (NT-proBNP): findings from the Heart and Soul Study.
abstract: BACKGROUND
  Anaemia is associated with elevated levels of natriuretic peptides. Whether the association of anaemia with natriuretic peptides is independent of other cardiovascular risk factors is unclear.
  
  
  METHODS
  This was a cross-sectional study of 809 ambulatory patients with coronary heart disease (CHD) and no history of heart failure (HF). We evaluated the extent to which the relationship between haemoglobin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) was explained by differences in cardiovascular risk factors, inflammation, and kidney dysfunction.
  
  
  RESULTS
  Of the 809 participants, 189 (23%) had anaemia (haemoglobin <13 g/dL). Haemoglobin (as a continuous variable) was inversely associated with log NT-proBNP (beta coefficient -.28, p<.0001). This association was considerably attenuated after accounting for cardiovascular risk factors, C-reactive protein, and kidney dysfunction. However, haemoglobin remained independently associated with log NT-proBNP even after adjustment for these variables (beta coefficient -.11, p=0.0003). Each 1 g/dL decrease in haemoglobin was associated with a 20% greater odds of having NT-proBNP in the highest quartile.
  
  
  CONCLUSIONS
  The relationship between anaemia and NT-proBNP is largely explained by differences in cardiovascular risk factors, ventricular function, myocardial ischaemia, inflammation, and kidney function. Nonetheless, haemoglobin appears to be inversely associated with NT-proBNP even after adjustment for these risk factors.
authors.affiliation: Department of Medicine, Johns Hopkins University, United States.
authors.forename: Arati S
authors.initials: AS
authors.lastname: Desai
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
authors.forename: Alan H B
authors.initials: AH
authors.lastname: Wu
authors.forename: Sadia
authors.initials: S
authors.lastname: Ali
authors.forename: Mary A
authors.initials: MA
authors.lastname: Whooley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000175:diagnosis*; D003327:Coronary Disease / Q000097:blood* / Q000150:complications; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D007674:Kidney Diseases / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D006454:Hemoglobins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain