Circulating plasma NT-proBNP predicts subclinical coronary atherosclerosis on CT angiography among older adults in Uganda

• Published in: BMC research notes Vol. 16; no. 1; p. 107
• Main Authors: Shakil, Saate S, Temu, Tecla M, Kityo, Cissy, MMed, Geoffrey Erem MBChB, Bittencourt, Marcio S, Longenecker, Chris T
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19.06.2023; BioMed Central; BMC
• Subjects: Aged patients; Analysis; Angiography; Arteriosclerosis; Atherosclerosis; Atherosclerosis - diagnostic imaging; Biomarkers; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Chronic kidney failure; Computed Tomography Angiography - adverse effects; Computer software industry; Coronary Angiography - adverse effects; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary heart disease; Coronary vessels; CT imaging; Development and progression; Diabetes; Diabetes mellitus; Diagnosis; Heart diseases; Heart failure; HIV; HIV (Viruses); HIV Infections - complications; Human immunodeficiency virus; Humans; Hyperlipidemia; Hypertension; Hypotheses; Inflammation; Investigations; Kidney diseases; Medical imaging; Medical research; Medicine, Experimental; Microvasculature; Myocardial stress; Natriuretic Peptide, Brain; Older people; Peptide Fragments; Peptides; Phenotypes; Plasma; Prospective Studies; R&D; Regression analysis; Research & development; Research Note; Risk Factors; Sensitivity analysis; Statins; Stress (Physiology); Uganda; Vein & artery diseases; Uganda; United States; Sub-Saharan Africa; United States > US; Kampala Uganda; Africa; Biomarkers; Cardiovascular disease; Myocardial stress; Coronary artery disease
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-023-06385-0

Phenotypes and mechanisms of cardiovascular disease (CVD) may differ across global populations. In sub-Saharan Africa (SSA), distinct environmental determinants may influence development and progression of atherosclerotic coronary artery disease (CAD). We investigated associations between 6 established markers of myocardial stress and subsequent subclinical CAD (sCAD), defined as presence of any atherosclerosis on coronary CT angiography (CCTA) in a 2-year prospective cohort of Ugandan adults enriched for cardiometabolic risk factors (RFs) and HIV. Six plasma biomarkers were measured baseline among 200 participants (50% with HIV) aged ≥ 45 years with ≥ 1 cardiovascular RF. At 2-year follow-up, 132 participants (52% with HIV) who returned underwent coronary CCTA. In logistic regression models adjusted for cardiovascular RFs (age, diabetes, hypertension, hyperlipidemia, smoking, obesity) and non-traditional RFs (HIV, chronic kidney disease), only NT-proBNP predicted subsequent subclinical CAD (p < 0.008, Bonferroni correction for multiple testing). In sensitivity analyses adjusted for ASCVD risk category (instead of individual RFs) in the baseline cohort with multiple imputation applied to missing year 2 CCTA data (n = 200), NT-proBNP remained significantly associated with subsequent CAD (p < 0.008). NT-proBNP consistently predicted subclinical CAD in Uganda in the absence of such an association among other markers of myocardial stress, suggesting a role for NT-proBNP in atherosclerosis independently of coronary microvascular dysfunction.