SynthesisThe lancet. Diabetes & endocrinology2016
Natriuretic peptides and integrated risk assessment for cardiovascular disease: an individual-participant-data meta-analysis.
Synthesis in The lancet. Diabetes & endocrinology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
119 citing papers in PubMed, 8 syntheses or guidelines pooled it, 215 citations in OpenAlex.
- Cardiac Troponins and Cardiovascular Disease Risk Prediction: An Individual-Participant-Data Meta-Analysis.Journal of the American College of Cardiology · 2025 · on this mapPooled it
- Current Trends in Biohumoral Screening for the Risk of Sudden Cardiac Death: A Systematic Review.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Diagnostic accuracy of natriuretic peptide screening for left ventricular systolic dysfunction in the community: systematic review and meta-analysis.ESC heart failure · 2023Pooled it
- Plasma Protein Profile of Incident Myocardial Infarction, Ischemic Stroke, and Heart Failure in 2 Cohorts.Journal of the American Heart Association · 2021Pooled it
- Plasma Protein Profile of Carotid Artery Atherosclerosis and Atherosclerotic Outcomes: Meta-Analyses and Mendelian Randomization Analyses.Arteriosclerosis, thrombosis, and vascular biology · 2021Pooled it
- Sex-Specific Associations of Cardiovascular Risk Factors and Biomarkers With Incident Heart Failure.Journal of the American College of Cardiology · 2020Pooled it
- Genome-wide meta-analysis associates HLA-DQA1/DRB1 and LPA and lifestyle factors with human longevity.Nature communications · 2017Pooled it
- High-Sensitivity Cardiac Troponin Concentration and Risk of First-Ever Cardiovascular Outcomes in 154,052 Participants.Journal of the American College of Cardiology · 2017Pooled it
- Plasma Protein Biomarkers and Long-Term Cardiovascular Mortality Risk in Patients With Chronic Coronary Heart Disease.Journal of the American Heart Association · 2024Trial
- High-Sensitivity Troponin T, NT-proBNP, and Cognitive Outcomes in SPRINT.Hypertension (Dallas, Tex. : 1979) · 2024Trial
- Associations of Ambulatory Blood Pressure Measurements With High-Sensitivity Troponin and Natriuretic Peptide Levels in SPRINT.American journal of hypertension · 2024Trial
- Relationship between the circulating N-terminal pro B-type natriuretic peptide and the risk of carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a CSCD-TCMCardiovascular diabetology · 2023Trial
- Trial
- Markers of Myocardial Stress, Myocardial Injury, and Subclinical Inflammation and the Risk of Sudden Death.Circulation · 2020Trial
- Cardiovascular Autonomic Neuropathy and Indices of Heart Failure in Type 2 Diabetes: The CANCAN Study.Diabetes, obesity & metabolism · 2026Article
- Prediction of incident heart failure in individuals without prior cardiovascular disease: the SCORE2-HF risk model.European heart journal · 2026Article
- Proteomic Profiling Captures Residual Cardiovascular Risk Beyond the PREVENT Model in Individuals With Cardiovascular-Kidney-Metabolic Syndrome Stages 2-3.Diabetes, obesity & metabolism · 2026Article
- Review
- Using SCORE2 with a risk chart or online calculator: impact on model performance, treatment eligibility, and cardiovascular disease prevention.European heart journal. Quality of care & clinical outcomes · 2026Article
- From acute diagnosis to longitudinal risk stratification: a paradigm shift in the clinical role of cardiac biomarkers.Frontiers in cardiovascular medicine · 2026Article
59 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
57 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundGuidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present by predicting heart failure and enhancing coronary heart disease and stroke risk assessment.
methodsIn this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes, with no language restrictions. We calculated risk ratios and measures of risk discrimination and reclassification across predicted 10 year risk categories (ie, <5%, 5% to <7·5%, and ≥7·5%), adding assessment of NT-proBNP concentration to that of conventional risk factors (ie, age, sex, smoking status, systolic blood pressure, history of diabetes, and total and HDL cholesterol concentrations). Primary outcomes were the combination of coronary heart disease and stroke, and the combination of coronary heart disease, stroke, and heart failure.
findingsWe recorded 5500 coronary heart disease, 4002 stroke, and 2212 heart failure outcomes among 95 617 participants without a history of cardiovascular disease in 40 prospective studies. Risk ratios (for a comparison of the top third vs bottom third of NT-proBNP concentrations, adjusted for conventional risk factors) were 1·76 (95% CI 1·56-1·98) for the combination of coronary heart disease and stroke and 2·00 (1·77-2·26) for the combination of coronary heart disease, stroke, and heart failure. Addition of information about NT-proBNP concentration to a model containing conventional risk factors was associated with a C-index increase of 0·012 (0·010-0·014) and a net reclassification improvement of 0·027 (0·019-0·036) for the combination of coronary heart disease and stroke and a C-index increase of 0·019 (0·016-0·022) and a net reclassification improvement of 0·028 (0·019-0·038) for the combination of coronary heart disease, stroke, and heart failure.
interpretationIn people without baseline cardiovascular disease, NT-proBNP concentration assessment strongly predicted first-onset heart failure and augmented coronary heart disease and stroke prediction, suggesting that NT-proBNP concentration assessment could be used to integrate heart failure into cardiovascular disease primary prevention.
fundingBritish Heart Foundation, Austrian Science Fund, UK Medical Research Council, National Institute for Health Research, European Research Council, and European Commission Framework Programme 7.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.