Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry

SAKAMOTO, DAISUKE; SOTOMI, YOHEI; MATSUOKA, YUKI; NAKATANI, DAISAKU; OKADA, KATSUKI; SUNAGA, AKIHIRO; KIDA, HIROTA; SATO, TAIKI; KITAMURA, TETSUHISA; SEO, MASAHIRO; YANO, MASAMICHI; HAYASHI, TAKAHARU; NAKAGAWA, AKITO; NAKAGAWA, YUSUKE; TAMAKI, SHUNSUKE; YASUMURA, YOSHIO; YAMADA, TAKAHISA; HIKOSO, SHUNGO; SAKATA, YASUSHI

doi:https://doi.org/10.1016/j.cardfail.2024.10.440

Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry

SAKAMOTO, DAISUKE; SOTOMI, YOHEI; MATSUOKA, YUKI et al.

Journal of Cardiac Failure, 2025, 31(5), 771-780

アクセス数:1,531件（2025-07-18 10:17 集計）

固定URL: https://hdl.handle.net/11094/101352

閲覧可能ファイル

ファイル	フォーマット	利用条件	サイズ	閲覧回数	利用開始日	説明	information
JCardFail_31_5_771	pdf	なし	2.00 MB	18	2025.05.20

Creative Commons : 表示

論文情報

ファイル出力 EndNote Basic出力 Mendeley出力

タイトル	Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry
著者	著者名 SAKAMOTO, DAISUKE
	NRID 1000090885253 1000090885253 ORCID 0000-0002-7564-2978 0000-0002-7564-2978 researchmap permalink sotomiyohei sotomiyohei 著者名 SOTOMI, YOHEI
	著者名 MATSUOKA, YUKI
	NRID 1000060444535 1000060444535 researchmap permalink dsyma dsyma Scopus Author ID 6603545219 6603545219 著者名 NAKATANI, DAISAKU
	NRID 1000020776489 1000020776489 researchmap permalink katsuki_okada katsuki_okada Scopus Author ID 13613369100 13613369100 著者名 OKADA, KATSUKI
	NRID 1000010812258 1000010812258 researchmap permalink 10812258 10812258 著者名 SUNAGA, AKIHIRO
	著者名 KIDA, HIROTA
	著者名 SATO, TAIKI
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 著者名 KITAMURA, TETSUHISA
	NRID 1000080731273 1000080731273 著者名 SEO, MASAHIRO
	著者名 YANO, MASAMICHI
	著者名 HAYASHI, TAKAHARU
	著者名 NAKAGAWA, AKITO
	著者名 NAKAGAWA, YUSUKE
	著者名 TAMAKI, SHUNSUKE
	NRID 1000030183669 1000030183669 著者名 YASUMURA, YOSHIO
	NRID 1000040649844 1000040649844 著者名 YAMADA, TAKAHISA
	NRID 1000030423164 1000030423164 researchmap permalink hikoso_osakauniv hikoso_osakauniv 著者名 HIKOSO, SHUNGO
	NRID 1000000397671 1000000397671 ORCID 0000-0002-5618-4721 0000-0002-5618-4721 researchmap permalink C4589 C4589 Scopus Author ID 35395964700 35395964700 著者名 SAKATA, YASUSHI
キーワード等	HFpEF
	acute heart failure
	biomarker
	NT-proBNP
内容	SAKAMOTO D., SOTOMI Y., MATSUOKA Y.U.K.I., et al. Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry. Journal of Cardiac Failure 31, 771 (2025); https://doi.org/10.1016/j.cardfail.2024.10.440.
抄録	Objectives: N-terminal pro brain natriuretic peptide (NT-proBNP) is a biomarker for myocardial stress that is used in diagnosing and prognosticating heart failure (HF). However, its interpretation is complicated by clinical factors. This study aims to clarify the prognostic value of NT-proBNP in patients with heart failure with preserved ejection fraction (HFpEF), and risk-prediction cutoffs considering various clinical factors. Methods: The study used data from the prospective, multicenter, observational Asian HFpEF registry. Patients with acute decompensated HF and left ventricular ejection fraction ≥ 50% were included. NT-proBNP levels were measured at discharge. The primary endpoint was a composite of all-cause death and hospitalization due to HF within 1 year after discharge. Results: A total of 1231 patients (83 [77–87] years old, 551 [45%] male) were enrolled, and 916 eligible patients were analyzed. The median NT-proBNP level was 1060 pg/m. In a multivariable logistic regression model, NT-proBNP was significantly associated with the primary endpoint (adjusted OR for log-transformed NT-proBNP: 2.71, 95% CI: 1.78–4.18; P < 0.001). Subgroup analysis revealed varying NT-proBNP distributions and differential safety cutoffs (329–929 pg/mL) at sensitivity of 0.8 based on factors such as atrial fibrillation and chronic kidney disease, maintaining its discriminatory performance (area under the curve: 0.587–0.734). Conclusions: NT-proBNP levels at discharge are a significant prognostic marker for HFpEF. Although NT-proBNP levels showed different distributions in various subgroups, and cutoff values were distinctive for each, the prognostic utility was found to be equivalent in almost all subgroups and had similar moderate discriminative performance. The study highlights the necessity of personalized NT-proBNP cutoffs for better management of and prognostication for patients with HFpEF.
出版者	Elsevier B.V.
収録物名	Journal of Cardiac Failure
巻(号)	31(5)
ページ	771-780
刊行年月	2025-05-13
言語	英語
ハンドルURL	https://hdl.handle.net/11094/101352
PISSN	10719164
eISSN	15328414
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1016/j.cardfail.2024.10.440
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Journal of Cardiac Failure. 2025, 31(5), p. 771-780
DC.title	Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry
DC.creator	SAKAMOTO, DAISUKE
	SOTOMI, YOHEI
	MATSUOKA, YUKI
	NAKATANI, DAISAKU
	OKADA, KATSUKI
	SUNAGA, AKIHIRO
	KIDA, HIROTA
	SATO, TAIKI
	KITAMURA, TETSUHISA
	SEO, MASAHIRO
	YANO, MASAMICHI
	HAYASHI, TAKAHARU
	NAKAGAWA, AKITO
	NAKAGAWA, YUSUKE
	TAMAKI, SHUNSUKE
	YASUMURA, YOSHIO
	YAMADA, TAKAHISA
	HIKOSO, SHUNGO
	SAKATA, YASUSHI
DC.publisher	Elsevier B.V.
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-05-13
DC.identifier	https://doi.org/10.1016/j.cardfail.2024.10.440
DC.subject	HFpEF
	acute heart failure
	biomarker
	NT-proBNP
DC.description	SAKAMOTO D., SOTOMI Y., MATSUOKA Y.U.K.I., et al. Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry. Journal of Cardiac Failure 31, 771 (2025); https://doi.org/10.1016/j.cardfail.2024.10.440.
DCTERMS.abstract	Objectives: N-terminal pro brain natriuretic peptide (NT-proBNP) is a biomarker for myocardial stress that is used in diagnosing and prognosticating heart failure (HF). However, its interpretation is complicated by clinical factors. This study aims to clarify the prognostic value of NT-proBNP in patients with heart failure with preserved ejection fraction (HFpEF), and risk-prediction cutoffs considering various clinical factors. Methods: The study used data from the prospective, multicenter, observational Asian HFpEF registry. Patients with acute decompensated HF and left ventricular ejection fraction ≥ 50% were included. NT-proBNP levels were measured at discharge. The primary endpoint was a composite of all-cause death and hospitalization due to HF within 1 year after discharge. Results: A total of 1231 patients (83 [77–87] years old, 551 [45%] male) were enrolled, and 916 eligible patients were analyzed. The median NT-proBNP level was 1060 pg/m. In a multivariable logistic regression model, NT-proBNP was significantly associated with the primary endpoint (adjusted OR for log-transformed NT-proBNP: 2.71, 95% CI: 1.78–4.18; P < 0.001). Subgroup analysis revealed varying NT-proBNP distributions and differential safety cutoffs (329–929 pg/mL) at sensitivity of 0.8 based on factors such as atrial fibrillation and chronic kidney disease, maintaining its discriminatory performance (area under the curve: 0.587–0.734). Conclusions: NT-proBNP levels at discharge are a significant prognostic marker for HFpEF. Although NT-proBNP levels showed different distributions in various subgroups, and cutoff values were distinctive for each, the prognostic utility was found to be equivalent in almost all subgroups and had similar moderate discriminative performance. The study highlights the necessity of personalized NT-proBNP cutoffs for better management of and prognostication for patients with HFpEF.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	101352
citation_title	Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry
citation_author	SAKAMOTO, DAISUKE
	SOTOMI, YOHEI
	MATSUOKA, YUKI
	NAKATANI, DAISAKU
	OKADA, KATSUKI
	SUNAGA, AKIHIRO
	KIDA, HIROTA
	SATO, TAIKI
	KITAMURA, TETSUHISA
	SEO, MASAHIRO
	YANO, MASAMICHI
	HAYASHI, TAKAHARU
	NAKAGAWA, AKITO
	NAKAGAWA, YUSUKE
	TAMAKI, SHUNSUKE
	YASUMURA, YOSHIO
	YAMADA, TAKAHISA
	HIKOSO, SHUNGO
	SAKATA, YASUSHI
citation_publisher	Elsevier B.V.
citation_language	英語
citation_date	2025-05-13
citation_journal_title	Journal of Cardiac Failure
citation_volume	31
citation_issue	5
citation_firstpage	771
citation_lastpage	780
citation_doi	https://doi.org/10.1016/j.cardfail.2024.10.440
citation_public_url	https://hdl.handle.net/11094/101352

Prognostic Utility and Cutoff Differences in NT-proBNP Levels Across Subgroups in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry

閲覧可能ファイル

論文情報

論文詳細を表示