title: N-terminal pro-brain natriuretic peptide and risk of cardiovascular events in a Japanese community: the Hisayama study.
abstract: OBJECTIVE
  Few studies have examined the association between natriuretic peptides and the incidence of cardiovascular disease (CVD) in Asian populations.
  
  
  RESULTS
  A total of 3104 community-dwelling Japanese individuals aged ≥40 years without history of CVD were followed up for 5 years. A total of 127 CVD events were identified. The age- and sex-adjusted incidence of CVD increased with increasing N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (<55, 55-124, 125-399, and ≥400 pg/mL) at baseline and was significantly higher even in subjects with a modest increase. This association remained robust even after adjustment for other potential risk factors (55-124 pg/mL: multivariate-adjusted hazard ratio=1.85 [95% CI 1.07-3.18], P=0.03; 125-399 pg/mL: 2.98 [95% CI 1.65-5.39], P<0.001; ≥400 pg/mL: 4.54 [95% CI 2.22-9.29], P<0.001). The multivariate-adjusted hazard ratios for the development of total CVD and its subtypes, coronary heart disease and stroke, were significantly increased by a 1 SD increment of the log NT-proBNP concentrations and were nearly equal among CVD subtypes. Similar findings were observed for stroke subtypes of ischemic stroke and intracerebral hemorrhage but not subarachnoid hemorrhage. The effects of the 1 SD increment in log NT-proBNP values were comparable in subjects with and without other cardiovascular risk factors, except for sex. The area under the receiver operating characteristic curve was significantly (P=0.006) increased by adding NT-proBNP values to the model including other potential risk factors.
  
  
  CONCLUSIONS
  Elevated NT-proBNP levels were shown to be a significant risk factor for the development of CVD and its subtypes in a general Japanese population, independently of other cardiovascular risk factors.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. doi@intmed2.med.kyushu-u.ac.jp
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hirakawa
authors.forename: Naoko
authors.initials: N
authors.lastname: Mukai
authors.forename: Fumie
authors.initials: F
authors.lastname: Ikeda
authors.forename: Masayo
authors.initials: M
authors.lastname: Fukuhara
authors.forename: Masanori
authors.initials: M
authors.lastname: Iwase
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology* / Q000208:ethnology; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000208:ethnology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain