Sex Differences in the Prognostic Power of Brain Natriuretic Peptide and N-Terminal Pro-Brain Natriuretic Peptide for Cardiovascular Events　― The Japan Morning Surge-Home Blood Pressure Study

• Published in: Circulation Journal Vol. 82; no. 8; pp. 2096 - 2102
• Main Authors: Taki, Mizuri, Ishiyama, Yusuke, Mizuno, Hiroyuki, Komori, Takahiro, Kono, Ken, Hoshide, Satoshi, Kario, Kazuomi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.07.2018
• Subjects: Brain natriuretic peptide; N-terminal pro-brain natriuretic peptide; Prognostic biomarker; Sex difference; Brain natriuretic peptide; Sex difference; N-terminal pro-brain natriuretic peptide; Prognostic biomarker
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-18-0375

Background:Brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are prognostic biomarkers. Although these 2 peptides differ with regard to biological characteristics, there are few reports on the differences between BNP and NT-proBNP with regard to cardiovascular events or according to sex.Methods and Results:Between 2005 and 2012, this study analyzed 3,610 of 4,310 Japanese outpatients (mean age, 65 years; men, n=1,664; women, n=1,947) with a history of at least one cardiovascular event who were recruited to the Japan Morning Surge-Home Blood Pressure Study. During an average 4-year follow-up, there were 129 cardiovascular events. Both median BNP (21.1 pg/mL; IQR, 10.9–40.6 pg/mL vs. 16.2 pg/mL, IQR, 7.2–36.2 pg/mL, P<0.001) and median NT-proBNP (54.7 pg/mL; IQR, 30.2–102.6 pg/mL vs. 44.9 pg/mL, IQR, 20.7–92.6 pg/mL, P<0.001) were significantly higher in women than in men. A 1-SD increment in log-transformed BNP (hazard ratio [HR], 2.18; 95% CI: 1.53–3.10) and NT-proBNP (HR, 2.39; 95% CI: 1.73–3.31) was associated with a significant increase in cardiovascular events in women; in men, only NT-proBNP showed this association. There was an interaction between log-transformed BNP (P=0.007) or NT-proBNP (P=0.001) and cardiovascular events according to sex.Conclusions:Both BNP and NT-proBNP predicted cardiovascular outcomes in a large Japanese clinical population. BNP and NT-proBNP were significantly stronger predictors in women than in men.