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Elevated n-terminal pro-brain natriuretic peptide is associated with mortality in tobacco smokers independent of airflow obstruction

Stamm, JA and Belloli, EA and Zhang, Y and Bon, J and Sciurba, FC and Gladwin, MT (2011) Elevated n-terminal pro-brain natriuretic peptide is associated with mortality in tobacco smokers independent of airflow obstruction. PLoS ONE, 6 (11).

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Abstract

Background: Tobacco use is associated with an increased prevalence of cardiovascular disease. N-terminal pro-brain natiuretic peptide (NT-proBNP), a widely available biomarker that is associated with cardiovascular outcomes in other conditions, has not been investigated as a predictor of mortality in tobacco smokers. We hypothesized that NT-proBNP would be an independent prognostic marker in a cohort of well-characterized tobacco smokers without known cardiovascular disease. Methods: Clinical data from 796 subjects enrolled in two prospective tobacco exposed cohorts was assessed to determine factors associated with elevated NT-proBNP and the relationship of these factors and NT-proBNP with mortality. Results: Subjects were followed for a median of 562 (IQR 252 - 826) days. Characteristics associated with a NT-proBNP above the median (≥49 pg/mL) were increased age, female gender, and decreased body mass index. By time-to-event analysis, an NT-proBNP above the median (≥49 pg/mL) was a significant predictor of mortality (log rank p = 0.02). By proportional hazard analysis controlling for age, gender, cohort, and severity of airflow obstruction, an elevated NT-proBNP level (≥49 pg/mL) remained an independent predictor of mortality (HR = 2.19, 95% CI 1.07-4.46, p = 0.031). Conclusions: Elevated NT-proBNP is an independent predictor of mortality in tobacco smokers without known cardiovascular disease, conferring a 2.2 fold increased risk of death. Future studies should assess the ability of this biomarker to guide further diagnostic testing and to direct specific cardiovascular risk reduction inventions that may positively impact quality of life and survival. © 2011 Stamm et al.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Stamm, JA
Belloli, EA
Zhang, Yzhang3@pitt.eduZHANG3
Bon, J
Sciurba, FCfcs@pitt.eduFCS
Gladwin, MT
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorKiechl, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 7 November 2011
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 6
Number: 11
DOI or Unique Handle: 10.1371/journal.pone.0027416
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
MeSH Headings: Aged; Cohort Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Natriuretic Peptide, Brain--analysis; Natriuretic Peptide, Brain--metabolism; Peptide Fragments--analysis; Peptide Fragments--metabolism; Proportional Hazards Models; Prospective Studies; Pulmonary Disease, Chronic Obstructive--etiology; Risk Factors; Smoking--mortality
Other ID: NLM PMC3210169
PubMed Central ID: PMC3210169
PubMed ID: 22087311
Date Deposited: 07 Sep 2012 20:35
Last Modified: 25 Jan 2019 23:55
URI: http://d-scholarship.pitt.edu/id/eprint/13994

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