Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: In heart failure patients, obesity is associated with better outcomes as compared to normal weight, a phenomenon called the obesity paradox. OBJECTIVE: To examine if obesity modifies the relationship between NT-proBNP and all-cause and cause-specific mortality in adults without coronary artery disease or heart failure history. METHODS: ). NT-proBNP levels were categorized as low (< 126 pg/mL) or high (≥ 126 pg/mL). Using Cox proportional hazard models, we examined effect modification by obesity using interaction, without and with adjusting for potential confounders. RESULTS: Of the 12 621 participants, 2794 (22%) died during 202 859 person-years follow-up. In adjusted models, normal-weight participants with high NT-proBNP had 2 times higher all-cause mortality risk than those with low NT-proBNP (HR = 2.05; 95%CI = 1.74, 2.41; p < 0.001); however, this mortality risk was 27% lower in obese participants (HR interaction = 0.73; 95%CI = 0.59, 0.92; p = 0.008). Similarly, in normal-weight participants, the difference in other-cause mortality risk between high and low NT-proBNP participants was significant in adjusted models (HR = 2.27; 95%CI = 1.81, 2.85; p < 0.001) and obese participants had 48% lower other-cause mortality risk between those with high and low NT-proBNP (interaction HR = 0.52; 95%CI = 0.36, 0.77; p = 0.001). Conversely, obesity did not modify the relationship between NT-proBNP and cardiovascular or cancer mortality. CONCLUSIONS: In patients free of heart failure or coronary artery disease, obesity may be protective against mortality associated with high NT-proBNP.
Source: Clinical Cardiology
DOI: 10.1002/clc.70044
Authors: Rupinder Kaur Bahniwal, Nargiza Sadr, Colleen Schinderle, Cynthia J. Avila, Julie Sill, Rehan Qayyum
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,460
OpenAlex ID: W4404182640