While elevated levels of NT-proBNP are known to be associated with a higher risk of typical MIs, less is known about the relationship between NT-proBNP and very small non ST-elevation MIs, also known as microsize MIs. We evaluated the association of baseline NT-proBNP with risk of incident microsize MIs, typical MIs and acute fatal CHD using a case-cohort study design in REGARDS, a national cohort of 30,239 US community-dwelling black and white adults aged >45 recruited from 2003 to 2007. We found that NT-proBNP was independently and strongly associated with all CHD endpoints, but the risk for incident microsize MI was the greatest in magnitude. This association persisted when taking fatal CHD into account as well as when participants with suspected heart failure were excluded. Our findings suggest that microsize MIs represent a unique population of CHD events, which may differ from typical MIs with respect to risk factors and underlying pathophysiology.
Primary Investigator:Dr. Madeline R. Sterling
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