Open AccessN‐terminal pro‐B‐type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure
Author(s) -
Tromp Jasper,
Richards Arthur Mark,
Tay Wan Ting,
Teng TiewHwa K.,
Yeo Poh Shuan Daniel,
Sim David,
Jaufeerally Fazlur,
Leong Gerard,
Ong Hean Yee,
Ling Lieng Hsi,
Veldhuisen Dirk J.,
Jaarsma Tiny,
Voors Adriaan A.,
Meer Peter,
Boer Rudolf A.,
Lam Carolyn S.P.
Publication year - 2018
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12252
Subject(s) - medicine , heart failure , hazard ratio , natriuretic peptide , ejection fraction , cardiology , confidence interval , atrial fibrillation , renal function
Aims N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) is the most frequently used biomarker in heart failure (HF), but its prognostic utility across ethnicities is unclear. Methods and results This study included 546 Caucasians with HF from the Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure and 578 Asians with HF from the Singapore Heart Failure Outcomes and Phenotypes study. NT‐proBNP was measured at discharge after HF hospitalization. The studied outcome was a composite of all‐cause mortality and HF hospitalization at 18 months. Compared with Caucasian patients, Asian patients were younger (63 ± 12 vs. 71 ± 11 years); less often female (26% vs. 39%); and had lower body mass index (26 vs. 27 kg/m 2 ), better renal function (61 ± 37 vs. 54 ± 20 mL/min/1.73 m 2 ), lower rates of atrial fibrillation (25% vs. 46%), strikingly higher rates of diabetes (59% vs. 30%), and higher rates of hypertension (76% vs. 44%). Despite these clear inter‐group differences in individual drivers of NT‐proBNP, average levels were similar in Asians [2709 (1350, 6302) pg/mL] and Caucasians [2545 (1308, 5484) pg/mL] ( P = 0.514). NT‐proBNP was strongly associated with outcome [hazard ratio 1.28 (per doubling), 95% confidence interval 1.18–1.39, P < 0.001], regardless of ethnicity ( P interaction = 0.719). NT‐proBNP was similarly associated with outcome in HF with reduced and preserved ejection fraction in Asian ( P interaction = 0.776) and Caucasian patients ( P interaction = 0.558). Conclusions NT‐proBNP has similar prognostic performance in Asians and Caucasians with HF despite ethnic differences in known clinical determinants of plasma NT‐proBNP.