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. 2025 Apr 1;14(7):2407.
doi: 10.3390/jcm14072407.

Modest NT-proBNP Elevation in Septuagenarians Without Heart Failure Is Not Associated with Cardiac Alterations or Cardiovascular Outcomes

Cristina Oliveira da Silva  1   2 , Camilla Hage  1   2 , Jonas Johnson  1 , Magnus Bäck  1   2 , Anikó I Nagy  2   3 , Emma Svennberg  2   4 , Larissa Bastos  5 , Johan Engdahl  5 , Faris Al-Khalili  5 , Lars Lund  1   2 , Aristomenis Manouras  1   2
Affiliations

Modest NT-proBNP Elevation in Septuagenarians Without Heart Failure Is Not Associated with Cardiac Alterations or Cardiovascular Outcomes

Cristina Oliveira da Silva et al. J Clin Med. .

Abstract

Background/Objectives: To assess the association between moderate N-terminal natriuretic peptide (NT-proBNP) and cardiac alterations and prognosis in septuagenarians without heart failure (HF). Methods: From the STROKESTOP II screening study, 230 individuals aged 75/76 years with NT-proBNP < 900 ng/L were randomly selected. Subjects with persistent atrial fibrillation (AF), more than mild valvular disease, or HF were excluded. Echocardiography was performed. NT-proBNP ≥ 125 ng/L and paroxysmal AF (pAF) on thumb ECG were used as grouping variables. Participants were followed up during a median of 5 years for cardiovascular mortality, HF, AF, and cerebrovascular events. Cox regression analysis was employed for prognostic assessment. Results: Three groups were identified: SR ≥ 125 (n = 94, no pAF and NT-proBNP ≥ 125 ng/L), pAF (n = 77, pAF and NT-proBNP ≥ 125 ng/L), and controls (n = 30, no pAF and NT-proBNP < 125 ng/L). NT-proBNP was not associated with structural (left atrial volume and left ventricular (LV) mass) or functional (E/e', LV strain) alterations in any group (p > 0.05). Cardiovascular risk factors (HR: 4.6; CI = 1.7-12.3; p = 0.002), but not NT-proBNP (HR: 1.9; CI = 0.7-5.1; p = 0.2), entailed a prognostic value for the composite endpoint of HF, AF, and cardiovascular death. Conclusions: In septuagenarians without HF, modest NT-proBNP elevation was not associated with echocardiographic changes or prognosis.

Keywords: N-terminal pro-brain natriuretic peptide; age; atrial fibrillation; echocardiography; heart failure.

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Conflict of interest statement

Emma Svennberg is supported by the Stockholm County Council (Clinical researcher appointment), the Swedish Research Council (DNR 2022-01466), the Swedish Heart and Lung foundation, and CIMED, and has received lecture fees from Bayer, Bristol-Myers Squibb-Pfizer, Boehringer- Ingelheim, Johnson & Johnson, and Merck Sharp & Dohme. Johan Engdahl has received consultant or lecture fees from Roche Diagnostics, Pfizer, Bristol Myers Squibb, Boehringer Ingelheim, Piotrode, and Philips. Research grants were received from the Swedish Research Council, the Swedish Heart and Lung Foundation, the Swedish Innovation Agency, and the Stockholm Region. Faris Al-Khalili has received consultant or lecture fees from Pfizer, Bristol Myers Squibb, and Boehringer Ingelheim Anikó I. Nagy was funded by the K-146732 OTKA grant of the Hungarian National Research Development and Innovation Office.

Figures

Figure 1
Figure 1
NT-proBNP levels in patients without and with morphological and functional abnormalities. Cumulative score of cardiac abnormalities was calculated as recommended by Pieske et al. (A) Cohorts without paroxysmal atrial fibrillation (pAF), (B) patients with pAF [12].
Figure 2
Figure 2
Diastolic function and filling pressure assessment.
See this image and copyright information in PMC

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