Heart failure & cardiomyopathies
Modification of the Association of B-Type Natriuretic Peptides With Mortality and Hospitalization Outcomes by Sex
Authors' conclusion
Sex modifies the association between NP concentrations and all-cause mortality or cardiovascular hospitalizations. Prognostically, interpretation of NP levels should consider effect modification by sex.
Study context
- Population
- All patients (aged ≥40 years) undergoing natriuretic peptide (NP) testing in Ontario, Canada (2015–2020)Two test cohorts · BNP tests (median 75 years; 48.0% females) 91,017 · N-terminal pro-BNP (NT-proBNP) tests (74 years; 48.6% females) 81,578
- Exposure
- sex-by-NP interactions for 1-year outcomes; sex-specific analyses for continuously increasing NP concentrations
- Outcome
- Adjusted 1-year all-cause mortality at a BNP of 400 ng/L
- Follow-up
- 1 year
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Adjusted 1-year all-cause mortality at an NT-proBNP of 900 ng/L
Sex interaction for mortality outcomes
- BNP sex interaction
- P = 0.002
- NT-proBNP sex interaction
- P = 0.03
Cardiovascular hospitalization, BNP
- Risk higher in males at lower concentrations but higher in females at higher concentrations
- P-interaction = 0.005
Cardiovascular hospitalization, NT-proBNP
- Risk higher in males at lower NP concentrations, but the gap narrowed at higher NP levels
- P interaction = 0.03
Original publication
Modification of the Association of B-Type Natriuretic Peptides With Mortality and Hospitalization Outcomes by Sex. JACC Adv. Published 24 July 2025. doi:10.
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