title: N-terminal fragment of B-type natriuretic peptide predicts coexisting subclinical heart and vessel disease.
abstract: BACKGROUND
  Identification of preclinical cardiovascular disease represents a challenge. We evaluate N-terminal proB-type natriuretic peptides (NT-proBNP) as markers of both cardiac and vascular subclinical disease in a community-based study including asymptomatic middle- aged study participants.
  
  
  RESULTS
  In total, 807 study participants without previous cardiovascular disease were recruited. They underwent thorough laboratory assessment (including NT-proBNP), ultrasound examination of heart and evaluation of coronary calcium score and carotid intima-media thickness, by computed tomography and ultrasound, respectively.Cardiac and vascular disease were defined as one among left ventricular (LV) ejection fraction less than 50% (3.1%), E/E' ratio more than 15 (9%), LV mass index more than 115 in men or more than 95 g/m in women (20%), LV end diastolic diameter more than 55 mm (2.5%), coronary calcium score more than 100 AU (13%), or carotid intima-media thickness more than 1.2 mm (21%), respectively. NT-proBNP [OR, 1.275; 95% (confidence interval) CI, 1.007-1.613, P < 0.001], 10-year Framingham risk score (FRS; OR 1.132; 95% CI, 1.058-1.212, P < 0.001) and lower creatinine clearance (OR, 0.983; 95% CI, 0.971-0.994, P < 0.001) predicted cardiac (220, 27%), whereas 10-year Framingham risk score (OR, 1.340; 95% CI, 1.245-1.674, P < 0.001) and NT-proBNP (OR, 1.501; 95% CI, 1.181-1.907, P < 0.001) predicted vascular involvement (215, 26%), at multivariate analysis. In total, 84 study participants (10.1%) had coexisting cardiac and vascular disease. NT-proBNP increased linearly from health study participants to study participants with only cardiac or vascular involvement, up to coexisting cardiovascular disease.
  
  
  CONCLUSIONS
  Coexisting cardiac and vascular involvement in asymptomatic study participants is common. Along with traditional risk factors, NT-proBNP appears a valuable biomarker for global subclinical heart and vessels disease.
authors.affiliation: aFondazione G. Monasterio CNR-Regione Toscana, Massa bInstitute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
authors.forename: Luigi E
authors.initials: LE
authors.lastname: Pastormerlo
authors.forename: Stefano
authors.initials: S
authors.lastname: Maffei
authors.forename: Daniele Della
authors.initials: DD
authors.lastname: Latta
authors.forename: Vladislav
authors.initials: V
authors.lastname: Chubuchny
authors.forename: Carla
authors.initials: C
authors.lastname: Susini
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
authors.forename: Concetta
authors.initials: C
authors.lastname: Prontera
authors.forename: Simona
authors.initials: S
authors.lastname: Storti
authors.forename: Claudio
authors.initials: C
authors.lastname: Passino
authors.forename: Emilio
authors.initials: E
authors.lastname: Pasanisi
authors.forename: Michele
authors.initials: M
authors.lastname: Emdin
authors.forename: Dante
authors.initials: D
authors.lastname: Chiappino
mesh_terms: D000368:Aged; D000886:Anthropometry / Q000379:methods; D050197:Atherosclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012372:ROC Curve; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D061205:Vascular Calcification / Q000175:diagnosis / Q000000981:diagnostic imaging
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain