Interaction of Body Mass Index on the Association Between N‐Terminal‐Pro‐b‐Type Natriuretic Peptide and Morbidity and Mortality in Patients With Acute Heart Failure: Findings From ASCEND‐HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure)
Bibliographic record
Abstract
Background Higher body mass index ( BMI ) is associated with lower circulating levels of N‐terminal‐pro‐b‐type natriuretic peptide ( NT ‐pro BNP ). The Interaction between BMI and NT ‐pro BNP with respect to clinical outcomes is not well characterized in patients with acute heart failure. Methods and Results A total of 686 patients from the biomarker substudy of the ASCEND ‐ HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated HF ) clinical trial with documented NT ‐pro BNP levels at baseline were included in the present analysis. Patients were classified by the World Health Organization obesity classification (nonobese: BMI <30 kg/m 2 , Class I obesity: BMI 30–34.9 kg/m 2 , Class II obesity BMI 35–39.9 kg/m 2 , and Class III obesity BMI ≥40 kg/m 2 ). We assessed baseline characteristics and 30‐ and 180‐day outcomes by BMI class and explored the interaction between BMI and NT ‐pro BNP for these outcomes. Study participants had a median age of 67 years (55, 78) and 71% were female. NT ‐pro BNP levels were inversely correlated with BMI ( P <0.001). Higher NT ‐pro BNP levels were associated with higher 180‐day mortality (adjusted hazard ratio for each doubling of NT ‐pro BNP, 1.40; 95% confidence interval, 1.16, 1.71; P <0.001), but not 30‐day outcomes. The effect of NT ‐pro BNP on 180‐day death was not modified by BMI class (interaction P =0.24). Conclusions The prognostic value of NT ‐pro BNP was not modified by BMI in this acute heart failure population. NT ‐pro BNP remains a useful prognostic indicator of long‐term mortality in acute heart failure even in the obese patient. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT00475852.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".