{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:56:27Z","timestamp":1785376587357,"version":"3.55.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002997","name":"Nierstichting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002997","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","award":["ERC CoG 818715"],"award-info":[{"award-number":["ERC CoG 818715"]}],"id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["917.13.350"],"award-info":[{"award-number":["917.13.350"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["2017\u201011"],"award-info":[{"award-number":["2017\u201011"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["2014\u201040"],"award-info":[{"award-number":["2014\u201040"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["2017\u201021"],"award-info":[{"award-number":["2017\u201021"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>There are limited data examining whether body mass index (BMI) influences the association between cardiovascular biomarkers and incident heart failure (HF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      Thirteen biomarkers representing key HF domains were measured: N\u2010terminal pro\u2010B\u2010type natriuretic peptide (NT\u2010proBNP), mid\u2010regional pro\u2010A\u2010type natriuretic peptide (MR\u2010proANP), cardiac troponin T (cTnT), C\u2010reactive protein, procalcitonin, galectin\u20103, C\u2010terminal pro\u2010endothelin\u20101 (CT\u2010proET\u20101), mid\u2010regional pro\u2010adrenomedullin, plasminogen activator inhibitor\u20101, copeptin, renin, aldosterone, and cystatin\u2010C. Associations of biomarkers with BMI were examined using linear regression models, and with incident HF using Cox regression models. We selected biomarkers significantly associated with incident HF, and evaluated whether BMI modified these associations. Among 8202 individuals, 41% were overweight (BMI 25\u201330\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), and 16% were obese (BMI \u226530\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Mean age of the cohort was 49\u2009years (range 28\u201375), and 50% were women. All biomarkers except renin were associated with BMI: inverse associations were observed with NT\u2010proBNP, MR\u2010proANP, CT\u2010proET\u20101 and aldosterone whereas positive associations were observed with the remaining biomarkers (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u20090.001). During 11.3\u2009\u00b1\u20093.1\u2009years of follow\u2010up, 357 HF events were recorded. Only NT\u2010proBNP, MR\u2010proANP and cTnT remained associated with incident HF (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and a significant biomarker*BMI interaction was not observed (interaction\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.1). Combined NT\u2010proBNP and cTnT measurements modestly improved performance metrics of the clinical HF model in overweight (\u0394C\u2010statistic\u00a0=\u00a00.024; likelihood ratio \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a038;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and obese (\u0394C\u2010statistic\u00a0=\u00a00.020; likelihood ratio \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a032;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) individuals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Plasma concentrations of several cardiovascular biomarkers are influenced by obesity. Only NT\u2010proBNP, MR\u2010proANP and cTnT were associated with incident HF, and BMI did not modify these associations. A combination of NT\u2010proBNP and cTnT improves HF risk prediction in overweight and obese individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2102","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T14:09:47Z","timestamp":1610719787000},"page":"396-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Relationship between body mass index, cardiovascular biomarkers and incident heart failure"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7781-2897","authenticated-orcid":false,"given":"Navin","family":"Suthahar","sequence":"first","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8627-7139","authenticated-orcid":false,"given":"Laura M.G.","family":"Meems","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1886-4451","authenticated-orcid":false,"given":"Dion","family":"Groothof","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Internal Medicine University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3356-6791","authenticated-orcid":false,"given":"Stephan J.L.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Internal Medicine University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3223-0906","authenticated-orcid":false,"given":"Ron T.","family":"Gansevoort","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Internal Medicine University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J.","family":"van Veldhuisen","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-9140","authenticated-orcid":false,"given":"Rudolf A.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The 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