Pro-B-type natriuretic peptide strongly predicts major cardiovascular events and cardiovascular mortality in coronary artery disease patients with NAFLD as well as in those without NAFLD

Abstract Introduction Elevated pro-B type natriuretic peptide (pro-BNP) has been found to be a marker of cardiovascular risk in several high-risk populations. Purpose The purpose of the study was to investigate the power of pro-BNP to predict MACE and cardiovascular death in patients with established coronary artery disease (CAD) and non-alcoholic fatty liver disease (NAFLD). Methods We therefore enrolled 568 patients with angiographically proven CAD. Prospectively, cardiovascular events were recorded over 9.6±4.5 years. Results At baseline, pro-BNP was not significantly different in patients with NAFLD (n=274) and in those who did not have NAFLD (685±1437 vs. 704±1283 pg/ml; p=0.722). During follow-up, 175 patients suffered MACE and 99 cardiovascular death; event rates of MACE and cardiovascular death were significantly higher in patients with NAFLD than in subjects without NAFLD (27.1% vs. 35.3%; p=0.037 and 21.7% vs. 13.7%; p=0.013, respectively). Pro-BNP predicted MACE and cardiovascular death in the total study population, with standardized adjusted hazard ratios (HR) of 1.23 1.05- 1.44; p=0.009 and 1.16 1.01-1.34; p0.001. Interaction terms pro-BNP x NAFLD were not significant for MACE and cardiovascular death (p=0.695 and p=0.096, respectively), indicating that the power of pro-BNP to predict these endpoints did not differ significantly between CAD patients with and those without NAFLD. Conclusion We conclude that pro-BNP strongly predicts major cardiovascular events and cardiovascular death in CAD patients with NAFLD as well as in those without NAFLD.