Developing a risk score for B-type natriuretic peptide (BNP) ≥ 100 pg/ml levels: the suita study

Increased plasma levels of B-type natriuretic peptide (BNP) serve as a biomarker for heart failure (HF). This study aimed to develop a risk score to predict elevated BNP levels using traditional cardiovascular disease (CVD) risk factors.

We analyzed data from 2809 Japanese individuals aged ≥ 40 years from the Suita Study, a population-based prospective cohort. All participants underwent follow-ups involving BNP measurements every two years. Developing BNP levels ≥ 100 pg/mL, a potential indicator of HF requiring treatment, was the outcome. Cox regression was applied to calculate hazard ratios for several CVD risk factors associated with developing BNP levels ≥ 100 pg/mL. Within a median follow-up period of 8 years, 339 participants developed BNP levels ≥ 100 pg/mL. The risk factors included older age, heavy smoking, former and heavy alcohol consumption, high blood pressure, estimated glomerular filtration rate < 45 mL/min/1.73 m², CVD history, cardiac murmur, arrhythmia including atrial fibrillation, and left ventricular hypertrophy. The prediction model performed well in terms of discrimination (C-statistics = 0.750) and calibration (p-value for goodness-of-fit > 0.150).

Our findings highlighted several CVD risk factors for BNP levels ≥ 100 pg/mL in the general Japanese population. Lifestyle modifications and regular health check-ups should be applied to reduce HF risk in vulnerable individuals.