N‐terminal pro‐B‐type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure

• Published in: ESC Heart Failure 2018-04, Vol.5 (2), p.279-287
• Main Authors: Tromp, Jasper, Richards, Arthur Mark, Tay, Wan Ting, Teng, Tiew‐Hwa 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.
• Format: Article
• Language: English
• Subjects: Age; Aged; Asian Continental Ancestry Group - ethnology; Asians; Biomarkers - blood; Blood pressure; Body mass index; Cardiac arrhythmia; Chronic obstructive pulmonary disease; Diabetes; Ejection fraction; Enzymes; Ethnicity; European Continental Ancestry Group - ethnology; Family medical history; Female; Follow-Up Studies; Heart attacks; Heart failure; Heart Failure - blood; Heart Failure - ethnology; HFpEF; Hospitalization - trends; Humans; Hypertension; Laboratories; Male; Middle Aged; Mortality; Natriuretic Peptide, Brain - blood; NT‐proBNP; Original; Original s; Peptide Fragments - blood; Peptides; Population; Prognosis; Prospective Studies; Protein Precursors; Regression analysis; Singapore - epidemiology; Stroke Volume; Studies; Variables
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.12252

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/m2), better renal function (61 ± 37 vs. 54 ± 20 mL/min/1.73 m2), 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