Elevated N-Terminal Pro-Brain Natriuretic Peptide Is Associated with Mortality in Tobacco Smokers Independent of Airflow Obstruction 英文参考文献.docVIP

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Elevated N-Terminal Pro-Brain Natriuretic Peptide Is Associated with Mortality in Tobacco Smokers Independent of Airflow Obstruction 英文参考文献.doc

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Elevated N-Terminal Pro-Brain Natriuretic Peptide Is Associated with Mortality in Tobacco Smokers Independent of Airflow Obstruction 英文参考文献

ElevatedN-TerminalPro-BrainNatriureticPeptideIs AssociatedwithMortalityinTobaccoSmokers IndependentofAirflowObstruction JasonA.Stamm1,ElizabethA.Belloli2,YingzeZhang3,JessicaBon3,FrankC.Sciurba3,MarkT. Gladwin3,4 * 1DivisionofPulmonaryandCriticalCareMedicine,GeisingerMedicalCenter,Danville,Pennsylvania,UnitedStatesofAmerica,2DivisionofGeneralInternalMedicine, UniversityofPittsburghMedicalCenter, Pittsburgh, Pennsylvania, UnitedStatesofAmerica, 3Division ofPulmonary, Allergy, andCritical CareMedicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America, 4Vascular Medicine Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania,UnitedStatesofAmerica Abstract Background:Tobaccouseisassociatedwithanincreasedprevalenceofcardiovasculardisease.N-terminalpro-brainnatiuretic peptide(NT-proBNP),awidelyavailablebiomarkerthatisassociatedwithcardiovascularoutcomesinotherconditions,hasnot beeninvestigatedasapredictorofmortalityintobaccosmokers.WehypothesizedthatNT-proBNPwouldbeanindependent prognosticmarkerinacohortofwell-characterizedtobaccosmokerswithoutknowncardiovasculardisease. Methods:Clinicaldatafrom796subjectsenrolledintwoprospectivetobaccoexposedcohortswasassessedtodetermine factorsassociatedwithelevatedNT-proBNPandtherelationshipofthesefactorsandNT-proBNPwithmortality. Results: Subjects were followed for a median of 562 (IQR 252 – 826) days. Characteristics associated with a NT-proBNP above the median ($49pg/mL) were increased age, female gender, and decreased body mass index. By time-to-event analysis, an NT-proBNP above the median ($49pg/mL) was a significant predictor of mortality (log rank p=0.02). By proportionalhazardanalysiscontrollingforage,gender,cohort,andseverityofairflowobstruction,anelevatedNT-proBNP level($49pg/mL)remainedanindependentpredictorofmortality(HR=2.19,95%CI1.07–4.46,p=0.031). Conclusions: Elevated NT-proBNP is an independent predictor of mortality in tobacco smokers without know