Prognostic association of plasma NT-proBNP levels in patients with microvascular angina -A report from the international cohort study by COVADIS-

Suda, A. et al. (2022) Prognostic association of plasma NT-proBNP levels in patients with microvascular angina -A report from the international cohort study by COVADIS-. International Journal of Cardiology: Heart and Vasculature, 43, 101139. (doi: 10.1016/j.ijcha.2022.101139) (PMID:36338319) (PMCID:PMC9626381)

Abstract

Background The aim of this study was to assess the prognostic association of plasma levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) with clinical outcomes of patients with microvascular angina (MVA). Methods In this international prospective cohort study of MVA by the Coronary Vasomotor Disorders International Study (COVADIS) group, we examined the association between plasma NT-proBNP levels and the incidence of major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina. Results We examined a total of 226 MVA patients (M/F 66/160, 61.9 ± 10.2 [SD] yrs.) with both plasma NT-proBNP levels and echocardiography data available at the time of enrolment. The median level of NT-proBNP level was 94 pg/ml, while mean left ventricular ejection fraction was 69.2 ± 10.9 % and E/e’ 10.7 ± 5.2. During follow-up period of a median of 365 days (IQR 365–482), 29 MACEs occurred. Receiver-operating characteristics curve analysis identified plasma NT-proBNP level of 78 pg/ml as the optimal cut-off value. Multivariable logistic regression analysis revealed that plasma NT-proBNP level ≥ 78 pg/ml significantly correlated with the incidence of MACE (odds ratio (OR) [95 % confidence interval (CI)] 3.11[1.14–8.49], P = 0.001). Accordingly, Kaplan-Meier survival analysis showed a significantly worse prognosis in the group with NT-proBNP ≥ 78 (log-rank test, P < 0.03). Finally, a significant positive correlation was observed between plasma NT-proBNP levels and E/e’ (R = 0.445, P < 0.0001). Conclusions These results indicate that plasma NT-proBNP levels may represent a novel prognostic biomarker for MVA patients.

• Item Type: Articles
• Additional Information: The Japanese Coronary Spasm Association (funded by the Japan Heart Foundation). CB received funding from the British Heart Foundation (PG/17/2532884; RE/18/6134217). CNBM and CJP received funding from contracts from the National Heart, Lung and Blood Institutes nos. N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164, grants U0164829, U01 HL649141, U01 HL649241, K23HL105787, T32HL69751, R01 HL090957, 1R03AG032631 from the National Institute on Aging, GCRC grant MO1-RR00425 from the National Center for Research Resources, the National Center for Advancing Translational Sciences Grant UL1TR000124 and UL1TR000064. JB received funding from The Hospital Research Foundation. PO and US received funding from the Berthold-Leibinger-Foundation, Germany.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Berry, Professor Colin
• Authors: Suda, A., Takahashi, J., Schwidder, M., Ong, P., Ang, D., Berry, C., Camici, P. G., Crea, F., Carlos Kaski, J., Pepine, C., Rimoldi, O., Sechtem, U., Yasuda, S., Beltrame, J. F., Noel Bairey Merz, C., Shimokawa, H., and Coronary Vasomotor Disorders International Study COVADIS Group, .
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: International Journal of Cardiology: Heart and Vasculature
• Publisher: Elsevier B.V.
• ISSN: 2352-9067
• ISSN (Online): 2352-9067
• Published Online: 31 October 2022
• Copyright Holders: Copyright © 2022 The Author(s).
• First Published: First published in International Journal of Cardiology: Heart and Vasculature 43:101139
• Publisher Policy: Reproduced under a Creative Commons licence