Association of Natriuretic Peptides With Cardiovascular Prognosis in Heart Failure With Preserved Ejection Fraction: Secondary Analysis of the TOPCAT Randomized Clinical Trial

JAMA Cardiology
Peder Langeland MyhreScott D Solomon

Abstract

Contemporary clinical trials of heart failure with preserved ejection fraction (HFpEF) apply natriuretic peptide (NP) thresholds to identify patients who are more likely to have the disease of interest and to enrich the baseline risk of the enrolled cohort. To determine whether age, race/ethnicity, obesity, renal function, and atrial fibrillation (AF) affect the levels of NPs in HFpEF and whether the prognostic significance of NPs varies in these clinically important subgroups. This secondary analysis of the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial (TOPCAT) evaluated the distribution and prognostic significance of NPs across 6 subgroups comprising 1057 adult patients (60%) in the Americas region of TOPCAT with symptomatic heart failure (HF) and a left ventricular ejection fraction of 45% or more with available NPs at baseline. Natriuretic peptides were log-transformed and standardized (expressed per 1 SD, z score) and assessed in 6 subgroups: age (cutoff, 70 years), black race, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared; cutoff, 30 kg/m2), waist circumference (cutoff, 102 cm for men, 88 cm for women), estimated glomerular filtrati...Continue Reading

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Jun 25, 2003·Circulation·Thomas J WangRamachandran S Vasan
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Apr 11, 2014·The New England Journal of Medicine·Bertram PittUNKNOWN TOPCAT Investigators
May 23, 2015·Journal of the American Heart Association·Deepak K GuptaScott D Solomon
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Citations

Apr 16, 2020·European Journal of Heart Failure·Muhammad Shahzeb KhanJaved Butler
Jul 17, 2020·Frontiers in Physiology·Tara C HitzemanRobin M Shaw
May 31, 2019·International Journal of Molecular Sciences·Daniela Maria TanaseMariana Floria
Aug 25, 2020·European Journal of Heart Failure·Juan R ReyUNKNOWN CARD-COVID Investigators
Nov 16, 2020·JACC. Heart Failure·Peder L MyhreScott D Solomon
Nov 15, 2019·Journal of the American College of Cardiology·Muthiah VaduganathanScott D Solomon
Dec 4, 2020·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Lingyu XuUNKNOWN AB HEART Investigators
Apr 29, 2021·Arquivos brasileiros de cardiologia·Devrim BozkurtSalih Kilic
Mar 17, 2020·JACC. Heart Failure·Nasrien E IbrahimJames L Januzzi

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