Abstract

Background: B-type natriuretic peptide (BNP) is associated with both coronary artery calcium, a marker of subclinical atherosclerosis, as well as myocardial ischemia and cardiac events. We examined the correlation of BNP with carotid intima-media thickness (IMT) in healthy asymptomatic population. Methods: The population of this study included 425 asymptomatic subjects (mean age 61 years, 53% male) free of cardiovascular disease who underwent IMT measurements by high-resolution carotid duplex Doppler studies. BNP levels were measured using the immune enzymometric assay (E test TOSOH II assay kit TOSHO, Japan). To reduce skewness, BNP levels were log transformed before regression analyses. Multivariate regression analyses adjusted for age, sex, smoking, blood pressure, eGFR, and other cardiovascular risk factors were performed. IMT was also categorized into two groups, increased and normal IMT, according to the age-modified IMT criteria. After the categorization, Student's t test was applied to evaluate the correlation between BNP and IMT. Results: In our study population, there were no significant differences in BNP levels between the two IMT categories. However, higher levels of BNP was observed amongst female subjects with increased IMT (BNP=27.25±1.36mm vs. 19.31±3.02mm for increased IMT vs. normal IMT, p=0.0171). Although there was no statistical difference in the levels of IMT between the sex (male 1.71±0.03pg/ml vs. female 1.61±0.03pg/ml, p=0.0595), higher IMT remained independently associated with higher BNP in female subjects. In multivariate models, log BNP (p=0.0302) was the second greatest estimator of IMT in females, while age (p=0.0002) and blood pressure (p=0.0314) were also statistically significant estimators. BNP, however, did not show any significant impact on IMT in males. Conclusions: Elevated BNP identifies a substantially increased likelihood of IMT progression. Therefore, BNP may serve as a marker of subclinical atherosclerosis. However its utility may be limited to female subjects.

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