NT-proBNP assessment improves prediction of cardiovascular events

Current guidelines for primary prevention of cardiovascular diseases focus on the prediction of coronary heart disease and stroke. However, in a significant proportion of people, heart failure is the first presentation of cardiovascular disease, which is not included in prediction models.

In this study published in Lancet Diabetes & Endocrinology, we aimed to test whether the natriuretic peptide NT-proBNP can improve existing algorithms for cardiovascular disease prediction and would allow to extend prediction efforts to include heart failure. The study was jointly led by Peter Willeit with John Danesh and Emanuele Di Angelantonio from the Department of Public Health and Primary Care, University of Cambridge.

We meta-analysed individual-participant data from the Natriuretic Peptides Studies Collaboration involving a total of 40 prospective studies with over 95000 participants. Assessment of NT-proBNP concentration, in addition to conventional risk factors, improved the prediction of first-onset coronary heart disease, stroke and heart failure. The improvement in risk prediction yielded by NT-proBNP measurement was at least as much as that of HDL cholesterol and about 3 times that of C-reactive protein.

Overall, this study highlights that NT-proBNP concentration assessment could serve as a multipurpose biomarker in new approaches that integrate heart failure into cardiovascular disease primary prevention.

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