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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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.