Body mass index modifies the major adverse cardiovascular and cerebral events risk of NT-proBNP in patients with acute coronary syndrome.

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetology & Metabolic Syndrome Pub Date : 2025-03-18 DOI:10.1186/s13098-025-01668-x

Xiaoquan He, Xiaojing Fang, Jiali Wang, Shumei Zhao, Xiaosong Ding, Hui Chen

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引用次数: 0

Abstract

Background: Little is known about the relationship between body mass index (BMI) and the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute coronary syndrome (ACS). This study aimed to investigate how BMI modifies the association between NT-proBNP levels and clinical outcomes in ACS patients.

Methods: A total of 11,757 ACS patients from the Cardiovascular Centre Beijing Friendship Hospital were recruited. The association between NT-proBNP and major adverse cardiovascular and cerebral events (MACCEs) was assessed using multivariate Cox proportional hazards models. The multiplicative interaction between NT-proBNP and BMI was evaluated using the Wald χ² test.

Results: During the median follow-up time of 3.04 (IQR: 1.07‒5.02) years (33,232 person-years), 1996 MACCEs were documented. A significant multiplicative interaction was observed between natural logarithm (Ln)-NT-proBNP and BMI (p for multiplicative interaction = 0.013). The categorical thresholds of NT-porBNP for the risk of MACCEs were 1559, 155, and 419 pg/ml for normoweight, overweight, and obese patients, respectively. When NT-proBNP levels were near-normal or mildly elevated (≤ 300 pg/ml), overweight and obese patients exhibited a higher event probability than normoweight patients at a given NT-proBNP level. However, an opposite trend was observed at significantly elevated NT-proBNP levels (> 300 pg/ml), with normoweight patients showing a higher event probability. When BMI and NT-proBNP were considered jointly, normoweight patients with elevated NT-proBNP had a significantly higher risk of MACCEs than overweight patients without elevated NT-proBNP (hazard ratio: 2.28; 95% confidence interval: 1.83‒2.84; p < 0.001).

Conclusion: The prognostic value of NT-proBNP in ACS patients varies with BMI, with the extent of NT-proBNP elevation playing a role in this relationship.

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体重指数改变急性冠状动脉综合征患者NT-proBNP的主要不良心血管和脑事件风险。

背景：关于急性冠脉综合征（ACS）患者身体质量指数（BMI）与n端前b型利钠肽（NT-proBNP）预后价值的关系，目前知之甚少。本研究旨在探讨BMI如何改变ACS患者NT-proBNP水平与临床结局之间的关系。方法：从北京友谊医院心血管中心招募11757例ACS患者。使用多变量Cox比例风险模型评估NT-proBNP与主要心血管和大脑不良事件（MACCEs）之间的关系。采用Wald χ2检验评估NT-proBNP与BMI之间的乘法相互作用。结果：中位随访时间为3.04年（IQR: 1.07-5.02）年（33,232人年），记录了1996例MACCEs。自然对数(Ln)-NT-proBNP与BMI之间存在显著的乘法相互作用（乘法相互作用的p = 0.013）。NT-porBNP对正常体重、超重和肥胖患者MACCEs风险的分类阈值分别为1559、155和419 pg/ml。当NT-proBNP水平接近正常或轻度升高（≤300 pg/ml）时，在给定NT-proBNP水平下，超重和肥胖患者比正常体重患者表现出更高的事件概率。然而，在NT-proBNP水平显著升高（300 pg/ml）时，观察到相反的趋势，体重正常的患者显示出更高的事件概率。当BMI和NT-proBNP联合考虑时，正常体重且NT-proBNP升高的患者发生MACCEs的风险显著高于未升高NT-proBNP的超重患者(风险比：2.28；95%置信区间：1.83-2.84；p结论：NT-proBNP对ACS患者的预后价值随BMI的变化而变化，NT-proBNP升高的程度在其中起作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-

CiteScore

6.20

自引率

0.00%

发文量

170

审稿时长

7.5 months

期刊介绍： Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.