The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations
Abstract A higher neprilysin activity has been suggested in women. In this retrospective analysis, we evaluated the association of sex and body mass index (BMI) with soluble neprilysin (sNEP) and recurrent admissions among 1021 consecutive HF outpatients. The primary and secondary endpoints were the...
Guardado en:
| Autores principales: | , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Nature Portfolio
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/3f865008d40347dd8a7c671ef2f12a45 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:3f865008d40347dd8a7c671ef2f12a45 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:3f865008d40347dd8a7c671ef2f12a452021-12-02T17:04:59ZThe influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations10.1038/s41598-021-85490-12045-2322https://doaj.org/article/3f865008d40347dd8a7c671ef2f12a452021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85490-1https://doaj.org/toc/2045-2322Abstract A higher neprilysin activity has been suggested in women. In this retrospective analysis, we evaluated the association of sex and body mass index (BMI) with soluble neprilysin (sNEP) and recurrent admissions among 1021 consecutive HF outpatients. The primary and secondary endpoints were the number of HF hospitalizations and all-cause mortality, respectively. The association between sNEP with either endpoint was evaluated across sex and BMI categories (≥ 25 kg/m2 vs. < 25 kg/m2). Bivariate count regression (Poisson) was used, and risk estimates were expressed as incidence rates ratio (IRR). During a median follow-up of 6.65 years (percentile 25%-percentile 75%:2.83–10.25), 702 (68.76%) patients died, and 406 (40%) had at least 1 HF hospitalization. Median values of sNEP and BMI were 0.64 ng/mL (0.39–1.22), and 26.9 kg/m2 (24.3–30.4), respectively. Left ventricle ejection fraction was < 40% in 78.9% of patients, and 28% were women. In multivariable analysis, sNEP (main effect) was positively associated with HF hospitalizations (p = 0.001) but not with mortality (p = 0.241). The predictive value of sNEP for HF hospitalizations varied non-linearly across sex and BMI categories (p-value for interaction = 0.003), with significant and positive effect only on women with BMI ≥ 25 kg/m2 (p = 0.039). For instance, compared to men, women with sNEP of 1.22 ng/mL (percentile 75%) showed a significantly increased risk (IRRs: 1.26; 95% CI: 1.05–1.53). The interaction analysis for mortality did not support a differential prognostic effect for sNEP (p = 0.072). In conclusion, higher sNEP levels in overweight women better predicted an increased risk of HF hospitalization.Julio NúñezEduardo NúñezElena Revuelta-LópezGema MiñanaJaume BarallatVicent BodiJuan SanchisAlberto AimoMichele EmdinJosep LupónOliver HusserAntoni Bayes-GenisNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Julio Núñez Eduardo Núñez Elena Revuelta-López Gema Miñana Jaume Barallat Vicent Bodi Juan Sanchis Alberto Aimo Michele Emdin Josep Lupón Oliver Husser Antoni Bayes-Genis The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| description |
Abstract A higher neprilysin activity has been suggested in women. In this retrospective analysis, we evaluated the association of sex and body mass index (BMI) with soluble neprilysin (sNEP) and recurrent admissions among 1021 consecutive HF outpatients. The primary and secondary endpoints were the number of HF hospitalizations and all-cause mortality, respectively. The association between sNEP with either endpoint was evaluated across sex and BMI categories (≥ 25 kg/m2 vs. < 25 kg/m2). Bivariate count regression (Poisson) was used, and risk estimates were expressed as incidence rates ratio (IRR). During a median follow-up of 6.65 years (percentile 25%-percentile 75%:2.83–10.25), 702 (68.76%) patients died, and 406 (40%) had at least 1 HF hospitalization. Median values of sNEP and BMI were 0.64 ng/mL (0.39–1.22), and 26.9 kg/m2 (24.3–30.4), respectively. Left ventricle ejection fraction was < 40% in 78.9% of patients, and 28% were women. In multivariable analysis, sNEP (main effect) was positively associated with HF hospitalizations (p = 0.001) but not with mortality (p = 0.241). The predictive value of sNEP for HF hospitalizations varied non-linearly across sex and BMI categories (p-value for interaction = 0.003), with significant and positive effect only on women with BMI ≥ 25 kg/m2 (p = 0.039). For instance, compared to men, women with sNEP of 1.22 ng/mL (percentile 75%) showed a significantly increased risk (IRRs: 1.26; 95% CI: 1.05–1.53). The interaction analysis for mortality did not support a differential prognostic effect for sNEP (p = 0.072). In conclusion, higher sNEP levels in overweight women better predicted an increased risk of HF hospitalization. |
| format |
article |
| author |
Julio Núñez Eduardo Núñez Elena Revuelta-López Gema Miñana Jaume Barallat Vicent Bodi Juan Sanchis Alberto Aimo Michele Emdin Josep Lupón Oliver Husser Antoni Bayes-Genis |
| author_facet |
Julio Núñez Eduardo Núñez Elena Revuelta-López Gema Miñana Jaume Barallat Vicent Bodi Juan Sanchis Alberto Aimo Michele Emdin Josep Lupón Oliver Husser Antoni Bayes-Genis |
| author_sort |
Julio Núñez |
| title |
The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_short |
The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_full |
The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_fullStr |
The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_full_unstemmed |
The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_sort |
influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/3f865008d40347dd8a7c671ef2f12a45 |
| work_keys_str_mv |
AT julionunez theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT eduardonunez theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT elenarevueltalopez theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT gemaminana theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT jaumebarallat theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT vicentbodi theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT juansanchis theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT albertoaimo theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT micheleemdin theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT joseplupon theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT oliverhusser theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT antonibayesgenis theinfluenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT julionunez influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT eduardonunez influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT elenarevueltalopez influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT gemaminana influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT jaumebarallat influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT vicentbodi influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT juansanchis influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT albertoaimo influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT micheleemdin influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT joseplupon influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT oliverhusser influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations AT antonibayesgenis influenceofsexandbodymassindexontheassociationbetweensolubleneprilysinandriskofheartfailurehospitalizations |
| _version_ |
1718381787568144384 |