title: The prognostic value of the plasma N-terminal pro-brain natriuretic peptide level on all-cause death and major cardiovascular events in a community-based population.
abstract: BACKGROUND
  Despite growing evidence that N-terminal pro-brain natriuretic peptide (NT-proBNP) has an important prognostic value for patients with cardiovascular disease, chronic kidney disease, etc, the prognostic significance of NT-proBNP levels in the general population has not been established. The aim of this study was to evaluate the clinical significance of NT-proBNP in a community population.
  
  
  METHODS
  This is a community-based prospective survey of residents from two communities in Beijing conducted for a routine health status checkup. Out of 1,860 individuals who were eligible for inclusion from 2007 to 2009, 1,499 completed a follow-up and were assessed for the prognostic value of NT-proBNP in 2013. A questionnaire was used for end point events. Anthropometry and blood pressure were measured. Plasma NT-proBNP, creatinine, lipids, and glucose were determined.
  
  
  RESULTS
  A total of 1,499 subjects with complete data were included in the analysis. Participants were divided into four groups according to baseline NT-proBNP levels (quartile 1, <19.8 pg/mL; quartile 2, 19.8-41.6 pg/mL; quartile 3, 41.7-81.8 pg/mL; quartile 4, ≥81.9 pg/mL). During a median 4.8-year follow-up period, the all-cause mortality rate rose from 0.8% in the lowest concentration NT-proBNP group (<19.8 pg/mL) to 7.8% in the highest NT-proBNP group (≥81.9 pg/mL; P<0.001). The incidence of major adverse cardiovascular events (MACEs) increased from 3.1% in the lowest NT-proBNP group to 18.9% in the highest group (P<0.001). Individuals in the highest NT-proBNP group (≥81.9 pg/mL) were associated with higher risk of all-cause death and MACEs compared with the lowest NT-proBNP group using Kaplan-Meier survival curves and the Cox proportional hazard model after adjusting for age, sex, and traditional risk factors.
  
  
  CONCLUSIONS
  The plasma NT-proBNP level is a strong and independent prognosis factor for all-cause death and MACEs in the community population. The NT-proBNP cut-point for the prognostic value remains to be further studied. NT-proBNP is a strong and independent prognostic factor for all-cause death and MACEs in individuals older than 65 years and MACEs in individuals younger than 65 years.
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Qiwei
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Wenkai
authors.initials: W
authors.lastname: Xiao
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Yongyi
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Ye
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Leiming
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Peng
authors.initials: P
authors.lastname: Gao
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Bai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000401:mortality*; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine
keywords: NT-proBNP; community population; prognosis