{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:28:33Z","timestamp":1761060513855,"version":"3.41.2"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,2,6]]},"abstract":"\n Background<\/jats:title>\n \n Higher body mass index (\n BMI<\/jats:styled-content>\n ) is associated with lower circulating levels of N\u2010terminal\u2010pro\u2010b\u2010type natriuretic peptide (\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n ). The Interaction between\n BMI<\/jats:styled-content>\n and\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n with respect to clinical outcomes is not well characterized in patients with acute heart failure.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A total of 686 patients from the biomarker substudy of the\n ASCEND<\/jats:styled-content>\n \u2010\n HF<\/jats:styled-content>\n (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated\n HF<\/jats:styled-content>\n ) clinical trial with documented\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels at baseline were included in the present analysis. Patients were classified by the World Health Organization obesity classification (nonobese:\n BMI<\/jats:styled-content>\n <30\u00a0kg\/m\n 2<\/jats:sup>\n , Class I obesity:\n BMI<\/jats:styled-content>\n 30\u201334.9\u00a0kg\/m\n 2<\/jats:sup>\n , Class\n II<\/jats:styled-content>\n obesity\n BMI<\/jats:styled-content>\n 35\u201339.9\u00a0kg\/m\n 2<\/jats:sup>\n , and Class\n III<\/jats:styled-content>\n obesity\n BMI<\/jats:styled-content>\n \u226540\u00a0kg\/m\n 2<\/jats:sup>\n ). We assessed baseline characteristics and 30\u2010 and 180\u2010day outcomes by\n BMI<\/jats:styled-content>\n class and explored the interaction between\n BMI<\/jats:styled-content>\n and\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n for these outcomes. Study participants had a median age of 67\u00a0years (55, 78) and 71% were female.\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels were inversely correlated with\n BMI<\/jats:styled-content>\n (\n P<\/jats:italic>\n <0.001). Higher\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels were associated with higher 180\u2010day mortality (adjusted hazard ratio for each doubling of\n NT<\/jats:styled-content>\n \u2010pro\n BNP,<\/jats:styled-content>\n 1.40; 95% confidence interval, 1.16, 1.71;\n P<\/jats:italic>\n <0.001), but not 30\u2010day outcomes. The effect of\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n on 180\u2010day death was not modified by\n BMI<\/jats:styled-content>\n class (interaction\n P<\/jats:italic>\n =0.24).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The prognostic value of\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n was not modified by\n BMI<\/jats:styled-content>\n in this acute heart failure population.\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n remains a useful prognostic indicator of long\u2010term mortality in acute heart failure even in the obese patient.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL:\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier: NCT00475852.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006740","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T09:47:33Z","timestamp":1518083253000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Interaction of Body Mass Index on the Association Between N\u2010Terminal\u2010Pro\u2010b\u2010Type Natriuretic Peptide and Morbidity and Mortality in Patients With Acute Heart Failure: Findings From ASCEND\u2010HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure)"],"prefix":"10.1161","volume":"7","author":[{"given":"Ankeet S.","family":"Bhatt","sequence":"first","affiliation":[{"name":"Department of Medicine, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren B.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Inova Heart & Vascular Institute, Falls Church, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew P.","family":"Ambrosy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Clare","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Coles","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emer","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun","family":"Krishnamoorthy","sequence":"additional","affiliation":[{"name":"Piedmont Heart Institute, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Stony Brook Heart Institute, Stony Brook, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Michael","family":"Felker","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin A.","family":"Ezekowitz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul W.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Inova Heart & Vascular Institute, Falls Church, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/HHF.0b013e318291329a"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs104"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31829e8776"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7492.625"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020233"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.050"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.555573"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.10.066"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000112582.16683.EA"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1100171"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.07.031"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2007.08.018"},{"key":"e_1_3_4_14_2","first-page":"i","article-title":"Obesity: preventing and managing the global epidemic. 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