Change in NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) Level and Risk of Dementia in Multi-Ethnic Study of Atherosclerosis (MESA)

Mohammad R. Ostovaneh, Kasra Moazzami, Kihei Yoneyama, Bharath A. Venkatesh, Susan R. Heckbert, Colin O. Wu, Steven Shea, Wendy S. Post, Annette L. Fitzpatrick, Gregory L. Burke, Hossein Bahrami, Otto A. Sanchez, Lori B. Daniels, Erin D. Michos, David A. Bluemke, João A.C. Lima

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Cross-sectionally measured NT-proBNP (N-Terminal pro-B-Type natriuretic peptide) is related to incident dementia. However, data linking changes in NT-proBNP to risk of future dementia are lacking. We aimed to examine the association of change in NT-proBNP over 3.2 years with incident dementia. We included 4563 participants in MESA (Multi-Ethnic Study of Atherosclerosis) prospective cohort who were free of cardiovascular disease at enrollment, had NT-proBNP level measured at MESA exams 1 (baseline, 2000-2002) and 3 (2004-2005), and had no diagnosis of dementia before exam 3. The association of change in NT-proBNP level between MESA exams 1 through 3 and all-cause hospitalized dementia (by International Classification of Diseases, Ninth Revision, codes) after MESA exam 3 (2004-2005) through 2015 was assessed using competing-risks Cox proportional hazard regression analysis. During 45 522 person-years of follow-up, 223 dementia cases were documented. Increase in log-NT-proBNP from MESA exams 1 through 3 was positively associated with incidence of dementia (multivariable hazard ratio, 1.28 [95% CI, 1.001-1.64]; P=0.049). An increase of at least 25% in NT-proBNP level from MESA exam 1 through 3 was associated with a 55% (P=0.02) increase in the risk of dementia in multivariable analysis. Addition of temporal NT-proBNP change to a model including risk factors and baseline NT-proBNP improved the prediction of dementia (Harrell C statistic from 0.85 to 0.87, P=0.049). Increase in NT-proBNP is independently associated with future all-cause hospitalized dementia and offers a moderately better predictive performance for risk of dementia compared with risk factors and baseline NT-proBNP. Clinical Trial Registration-URL: Unique identifier: NCT00005487.

Original languageEnglish (US)
Pages (from-to)316-323
Number of pages8
Issue number2
StatePublished - Feb 1 2020


  • cardiovascular diseases
  • cognition disorders
  • cohort studies
  • dementia
  • risk factors

ASJC Scopus subject areas

  • Internal Medicine


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