Int J Heart Fail.  2020 Jan;2(1):45-54. 10.36628/ijhf.2019.0005.

The Impact of Body Mass Index on the Prognostic Value of N-Terminal proB-Type Natriuretic Peptide in Patients with Heart Failure: an Analysis from the Korean Heart Failure (KorHF) Registry

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
  • 2Department of Biostatistics, Boramae Medical Center, Seoul, Korea
  • 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
  • 4Department of Cardiovascular Medicine, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Korea
  • 5Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
  • 6Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
  • 7Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 8Department of Internal Medicine, Yonsei University Wonju Christian Hospital, Wonju, Korea
  • 9Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea
  • 10Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Korea
  • 11Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea

Abstract

Background and Objectives
Although an inverse correlation between the level of amino (N)-terminal pro-brain natriuretic peptide (NT-proBNP) and body mass index (BMI) has been reported, the impact of BMI on the prognostic value of NT-proBNP has not been well addressed.
Methods
A total of 1,877 patients (67-year-old and 49.9% females) hospitalized for acute heart failure (HF) with documented NT-proBNP levels at baseline were included. Patients were classified into 2 groups by BMI (nonobese: BMI<23 kg/m2 and overweight or obese: BMI≥23 kg/m2). Clinical events during the follow-up including all-cause mortality and HF readmission were assessed.
Results
During the median follow-up of 828 days (interquartile range, 111–1,514 days), there were 595 cases of total mortality (31.7%), 600 cases of HF readmission (32.0%), and 934 cases of composite events (49.8%). In unadjusted analyses, higher NT-proBNP level was associated with all-cause mortality and composite events (all-cause mortality and HF readmission) in both patients with BMI<23 kg/m2 and those with BMI≥23 kg/m2. In adjusted analyses controlling for potential confounders, however, a higher NT-proBNP level was associated with all-cause mortality and composite events in patients with BMI<23 kg/m2, but not in those with BMI≥23 kg/m2.
Conclusions
The prognostic value of NT-proBNP was more significant in nonobese patients than in overweight and obese patients in this HF population. BMI should be considered when NT-proBNP is used for risk estimation in HF patients.

Keyword

Body mass index; Heart failure; NT-proBNP; Prognosis; Obesity
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