Clinical InvestigationsEffect of body mass index on natriuretic peptide levels in patients with acute congestive heart failure: A ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy
Section snippets
Study sample
The details of the PRIDE study have recently been described.7 The study examined 600 patients with acute dyspnea to evaluate the role of NT-proBNP levels in the diagnosis of acute CHF. For each subject, a study physician was provided with all hospital records pertaining to the subject, starting from the time of emergency department presentation through to the results of the 60-day follow-up. These records included (when available) office notes, hospital discharge records, and results of all
Results
Overall, 59 (29%) participants were overweight, 64 (31%) participants obese, and 81 (40%) were normal. Body mass index ranged from 15.5 to 51.7 kg/m2 (mean ± SD = 27.6 ± 6.6 kg/m2). Morbidly obese patients (BMI >40 kg/m2) accounted for 14 (7%) of the 204 study subjects. Characteristics of the study sample by clinical strata of BMI are shown in Table I. Overweight and obese patients were younger, had higher creatinine clearance, and a higher prevalence of diabetes (all P < .05) than patients
Discussion
Obesity affects more than 40 million Americans, and between 280 000 and 325 000 deaths are attributed to obesity annually in the United States.20 Both figures are rapidly increasing. Obesity-related illnesses, such as diabetes and hypertension, are risk factors for CHF,1., 2., 3. which represents a major source of morbidity and mortality among overweight and obese patients. As overweight and obese patients with dyspnea are often the most difficult to assess clinically, BNP assays have the
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