Supplemental Digital Content is available in the text. Cross-sectionally measured NT-proBNP (N-terminal pro-B-type natriuretic peptide) is related to incident dementia. However, data linking changes in NT-proBNP to risk of future dementia are lacking. We aimed to examine the association of change in NT-proBNP over 3.2 years with incident dementia. We included 4563 participants in MESA (Multi-Ethnic Study of Atherosclerosis) prospective cohort who were free of cardiovascular disease at enrollment, had NT-proBNP level measured at MESA exams 1 (baseline, 2000–2002) and 3 (2004–2005), and had no diagnosis of dementia before exam 3. The association of change in NT-proBNP level between MESA exams 1 through 3 and all-cause hospitalized dementia (by International Classification of Diseases, Ninth Revision, codes) after MESA exam 3 (2004–2005) through 2015 was assessed using competing-risks Cox proportional hazard regression analysis. During 45 522 person-years of follow-up, 223 dementia cases were documented. Increase in log-NT-proBNP from MESA exams 1 through 3 was positively associated with incidence of dementia (multivariable hazard ratio, 1.28 [95% CI, 1.001–1.64]; P=0.049). An increase of at least 25% in NT-proBNP level from MESA exam 1 through 3 was associated with a 55% (P=0.02) increase in the risk of dementia in multivariable analysis. Addition of temporal NT-proBNP change to a model including risk factors and baseline NT-proBNP improved the prediction of dementia (Harrell C statistic from 0.85 to 0.87, P=0.049). Increase in NT-proBNP is independently associated with future all-cause hospitalized dementia and offers a moderately better predictive performance for risk of dementia compared with risk factors and baseline NT-proBNP. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique identifier: NCT00005487.

中文翻译：

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动脉粥样硬化多种族研究 (MESA) 中 NT-proBNP（N 端前 B 型利钠肽）水平和痴呆风险的变化

补充数字内容在文本中可用。横断面测量的 NT-proBNP（N 端前 B 型利钠肽）与痴呆的发生有关。然而，缺乏将 NT-proBNP 的变化与未来痴呆症风险联系起来的数据。我们的目的是检查 3.2 年内 NT-proBNP 的变化与痴呆症的关联。我们纳入了 MESA（动脉粥样硬化多种族研究）前瞻性队列中的 4563 名参与者，他们在入组时没有心血管疾病，在 MESA 考试 1（基线，2000-2002）和 3（2004-2005）中测量了 NT-proBNP 水平，并且在检查 3 之前没有诊断出痴呆。 MESA 检查 1 到 3 之间 NT-proBNP 水平变化与全因住院痴呆（根据国际疾病分类，第九次修订，代码）在 MESA 考试 3（2004-2005）到 2015 年之后使用竞争风险 Cox 比例风险回归分析进行评估。在 45522 人年的随访中，记录了 223 例痴呆病例。MESA 检查 1 到 3 中 log-NT-proBNP 的增加与痴呆的发生率呈正相关（多变量风险比，1.28 [95% CI，1.001-1.64]；P=0.049）。在多变量分析中，从 MESA 检查 1 到 3，NT-proBNP 水平增加至少 25% 与痴呆风险增加 55% (P=0.02) 相关。将时间性 NT-proBNP 变化添加到包括风险因素和基线 NT-proBNP 的模型中，改善了痴呆的预测（Harrell C 统计量从 0.85 到 0.87，P=0.049）。NT-proBNP 的增加与未来的全因住院痴呆症独立相关，与风险因素和基线 NT-proBNP 相比，对痴呆症风险的预测性能略好。临床试验注册——网址：https://www.clinicaltrials.gov。唯一标识符：NCT00005487。