{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T13:23:27Z","timestamp":1793107407460,"version":"4.5.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a potent predictor of death and heart failure (HF) across multiple populations. We evaluated the prognostic importance of NT-proBNP in patients with acute myocardial infarction (MI) complicated by left ventricular systolic dysfunction, pulmonary congestion, or both and \u22651 of 8 risk-augmenting factors enrolled in the PARADISE-MI trial (Prospective ARNI vs ACE Inhibitor Trial to Determine Superiority in Reducing Heart Failure Events After Myocardial Infarction).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Patients were randomized to sacubitril\/valsartan 200 mg or ramipril 5 mg twice daily within 0.5 to 7 days of a MI. Patients with prior HF were excluded. NT-proBNP and hs-cTnT (high-sensitivity troponin T) were collected at randomization in a prespecified substudy of 1129 patients. The primary end point of PARADISE-MI was a composite of cardiovascular death or incident HF (hospitalization or outpatient symptomatic HF), analyzed as time-to-first event; additional end points included all-cause death and the composite of fatal or nonfatal MI or stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Median NT-proBNP was 1757 ng\/L (25th\u201375th percentiles, 896\u20133462 ng\/L) at randomization (4.0\u00b11.8 days after the index MI). Patients in the highest quartile of NT-proBNP were older, more commonly women and had more hypertension, atrial fibrillation, renal dysfunction, and pulmonary congestion on presentation (all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). NT-proBNP was strongly associated with the primary end point (adjusted hazard ratio, 1.45 per doubling of NT-proBNP; [95% CI, 1.23\u20131.70]), adjusted for clinical variables and baseline hs-cTnT. NT-proBNP was also independently associated with all-cause death (adjusted hazard ratio, 1.74 [95% CI, 1.38\u20132.21]) and fatal or nonfatal MI or stroke (adjusted hazard ratio, 1.24 [95% CI, 1.05\u20131.45]). NT-proBNP did not significantly modify the neutral treatment effect of sacubitril\/valsartan relative to ramipril (\n              <jats:italic>P<\/jats:italic>\n              interaction=0.46).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Within the first week of a high-risk MI NT-proBNP is associated with incident HF, death and atherosclerotic events. This prognostic information is independent of hs-cTnT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02924727.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.122.010259","type":"journal-article","created":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T09:00:41Z","timestamp":1682931641000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Prognostic Importance of NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) Following High-Risk Myocardial Infarction in the PARADISE-MI Trial"],"prefix":"10.1161","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct02924727","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5243-1959","authenticated-orcid":true,"given":"Karola S.","family":"Jering","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital and Harvard Medical School Boston, MA (K.S.J., B.L.C., M.A.P., S.D.S., E.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4215-9218","authenticated-orcid":true,"given":"Brian L.","family":"Claggett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital and Harvard Medical School Boston, MA (K.S.J., B.L.C., M.A.P., S.D.S., E.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3876-7568","authenticated-orcid":true,"given":"Marc A.","family":"Pfeffer","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital and Harvard Medical School Boston, MA (K.S.J., B.L.C., M.A.P., S.D.S., E.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0045-3291","authenticated-orcid":true,"given":"Christopher B.","family":"Granger","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC (C.B.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6635-1466","authenticated-orcid":true,"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[{"name":"Heart Centre, Ringshospitalet Copenhagen University Hospital, Denmark (L.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldrin F.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, CA (E.F.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2764-6779","authenticated-orcid":true,"given":"Aldo P.","family":"Maggioni","sequence":"additional","affiliation":[{"name":"ANMCO Research Center, Heart Care Foundation, Florence, Italy (A.P.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2516-0145","authenticated-orcid":true,"given":"Douglas L.","family":"Mann","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University, St Louis, MO (D.L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-3975","authenticated-orcid":true,"given":"John J.V.","family":"McMurray","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Scotland (J.J.V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret F.","family":"Prescott","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceutical Corporation, East Hanover, NJ (M.F.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean L.","family":"Rouleau","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al, QB, Canada (J.L.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-9597","authenticated-orcid":true,"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital and Harvard Medical School Boston, MA (K.S.J., B.L.C., M.A.P., S.D.S., E.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-2941","authenticated-orcid":true,"given":"Phillippe Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Cit\u00e9, Institut Universitaire de France, AP-HP (Assistance Publique-H\u00f4pitaux de Paris), FACT (French Alliance for Cardiovascular Trials) and INSERM U-1148, Paris, France (P.G.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9996-6128","authenticated-orcid":true,"given":"Dirk","family":"von Lewinski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Graz, Austria (D.v.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3472-626X","authenticated-orcid":true,"given":"Eugene","family":"Braunwald","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital and Harvard Medical School Boston, MA (K.S.J., B.L.C., M.A.P., S.D.S., 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