Heart failure & cardiomyopathiesMeta-analysis
Natriuretic Peptides, Body Mass Index and Heart Failure Risk: Pooled Analyses of SAVOR-TIMI 53, DECLARE-TIMI 58 and CAMELLIA-TIMI 61
- Pooled analysis of the SAVOR-TIMI 53, DECLARE-TIMI 58 and CAMELLIA-TIMI 61 randomised trials
Authors' conclusion
The risk of HHF varies across BMI categories for any given range of circulating NT-proBNP.
Study context
- Population
- Predominantly overweight or obese patients with established cardiometabolic disease
- Participants
- 24,455 participants · 3 RCTs
- Comparison
- Body mass index (BMI) <30 kg/m² vs BMI ≥40 kg/m²
- Outcome
- HHF across strata of baseline BMI and NT-proBNP
- Follow-up
- 2 years
Pooled result
As reported in the abstract
HHF, BMI <30 vs ≥40 kg/m² by NT-proBNP range
BMI ≥40 kg/m² vs BMI <30 kg/m²Adjusted hazard ratio (95% CI)
NT-proBNP <125 pg/ml: 0.0% vs. 0.6%
7.47(3.16–17.66)
NT-proBNP 125-<450 pg/ml: 1.3% vs. 4.0%
3.22(2.13–4.86)
NT-proBNP ≥450 pg/ml: 8.1% vs. 13.8%
1.87(1.35–2.60)
Further pooled results
Baseline NT-proBNP and BMI
- Median NT-proBNP, pg/ml (IQR 43-225)
- 96
- Median BMI, kg/m² (IQR 29-37)
- 33
- BMI ≥30 kg/m²
- 68%
- Significant inverse association between NT-proBNP and BMI, persisting after adjustment
- P < 0.001
Hospitalization for heart failure (HHF) with dapagliflozin vs placebo across BMI categories, elevated NT-proBNP (DECLARE-TIMI 58)
- Consistent HHF reduction across BMI categories (p-trend for HR)
- 0.60
- Absolute risk reduction (ARR) for BMI <30 to ≥40 kg/m²
- 2.2% to 4.7%
- p-trend for ARR
- 0.059
Original publication
Natriuretic Peptides, Body Mass Index and Heart Failure Risk: Pooled Analyses of SAVOR-TIMI 53, DECLARE-TIMI 58 and CAMELLIA-TIMI 61. Eur J Heart Fail. Published 4 January 2024. doi:10.1002/ejhf.3118
Summarised from the published abstract; every number is checked against it