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

Number of Access:1,531（2025-07-18 14:20 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/101352

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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
Creator	CreatorName SAKAMOTO, DAISUKE
	NRID 1000090885253 1000090885253 ORCID 0000-0002-7564-2978 0000-0002-7564-2978 researchmap permalink sotomiyohei sotomiyohei CreatorName SOTOMI, YOHEI
	CreatorName MATSUOKA, YUKI
	NRID 1000060444535 1000060444535 researchmap permalink dsyma dsyma Scopus Author ID 6603545219 6603545219 CreatorName NAKATANI, DAISAKU
	NRID 1000020776489 1000020776489 researchmap permalink katsuki_okada katsuki_okada Scopus Author ID 13613369100 13613369100 CreatorName OKADA, KATSUKI
	NRID 1000010812258 1000010812258 researchmap permalink 10812258 10812258 CreatorName SUNAGA, AKIHIRO
	CreatorName KIDA, HIROTA
	CreatorName 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 CreatorName KITAMURA, TETSUHISA
	NRID 1000080731273 1000080731273 CreatorName SEO, MASAHIRO
	CreatorName YANO, MASAMICHI
	CreatorName HAYASHI, TAKAHARU
	CreatorName NAKAGAWA, AKITO
	CreatorName NAKAGAWA, YUSUKE
	CreatorName TAMAKI, SHUNSUKE
	NRID 1000030183669 1000030183669 CreatorName YASUMURA, YOSHIO
	NRID 1000040649844 1000040649844 CreatorName YAMADA, TAKAHISA
	NRID 1000030423164 1000030423164 researchmap permalink hikoso_osakauniv hikoso_osakauniv CreatorName HIKOSO, SHUNGO
	NRID 1000000397671 1000000397671 ORCID 0000-0002-5618-4721 0000-0002-5618-4721 researchmap permalink C4589 C4589 Scopus Author ID 35395964700 35395964700 CreatorName SAKATA, YASUSHI
Subject	HFpEF
	acute heart failure
	biomarker
	NT-proBNP
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.
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.
Publisher	Elsevier B.V.
Source Title	Journal of Cardiac Failure
Volume (Issue)	31(5)
Page	771-780
Date of Issued	2025-05-13
Language	English
Handle URL	https://hdl.handle.net/11094/101352
PISSN	10719164
eISSN	15328414
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1016/j.cardfail.2024.10.440
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	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	English
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	English
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

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