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European Journal of Heart Failure 2007 9(9):886-891; doi:10.1016/j.ejheart.2007.06.005
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© 2007 European Society of Cardiology

Association between anaemia and N-terminal pro-B-type natriuretic peptide (NT-proBNP): Findings from the Heart and Soul Study

Arati S. Desaia, Kirsten Bibbins-Domingob,c,d, Michael G. Shlipakb,c,e, Alan H.B. Wud,f, Sadia Alie and Mary A. Whooleyb,c,e,*

a Department of Medicine, Johns Hopkins University United States
b Department of Medicine, University of California San Francisco, United States
c Department of Epidemiology and Biostatistics, University of California San Francisco, United States
d San Francisco General Hospital United States
e Veterans Affairs Medical Center San Francisco, United States
f Department of Laboratory Medicine, University of California San Francisco, United States

* Corresponding author. University of California, San Francisco, 4150 Clement Street (111A1), San Francisco, CA 94121, United States. Tel.: +1 415 750 2093; fax: +1 415 379 5573. E-mail address: mary.whooley{at}ucsf.edu


  Abstract

Background: Anaemia is associated with elevated levels of natriuretic peptides. Whether the association of anaemia with natriuretic peptides is independent of other cardiovascular risk factors is unclear.

Methods: This was a cross-sectional study of 809 ambulatory patients with coronary heart disease (CHD) and no history of heart failure (HF). We evaluated the extent to which the relationship between haemoglobin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) was explained by differences in cardiovascular risk factors, inflammation, and kidney dysfunction.

Results: Of the 809 participants, 189 (23%) had anaemia (haemoglobin <13 g/dL). Haemoglobin (as a continuous variable) was inversely associated with log NT-proBNP (beta coefficient – .28, p<.0001). This association was considerably attenuated after accounting for cardiovascular risk factors, C-reactive protein, and kidney dysfunction. However, haemoglobin remained independently associated with log NT-proBNP even after adjustment for these variables (beta coefficient – .11, p=0.0003). Each 1 g/dL decrease in haemoglobin was associated with a 20% greater odds of having NT-proBNP in the highest quartile.

Conclusions: The relationship between anaemia and NT-proBNP is largely explained by differences in cardiovascular risk factors, ventricular function, myocardial ischaemia, inflammation, and kidney function. Nonetheless, haemoglobin appears to be inversely associated with NT-proBNP even after adjustment for these risk factors.

Key Words: Anemia • Natriuretic peptide

Received December 15, 2006; Revised April 12, 2007; Accepted June 13, 2007


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