248-OR: Pro-B-Type Natriuretic Peptide Strongly Predicts Major Cardiovascular Events and Cardiovascular Mortality in Cardiovascular Disease Patients with NAFLD as Well as in Those without NAFLD

Elevated pro-B type natriuretic peptide (pro-BNP) has been found to be a marker of cardiovascular risk in several risk populations. However, its power to predict MACE and cardiovascular death in patients with the combination of established cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD) is unclear. We therefore enrolled 639 patients with established CVD, 385 with angiographically proven stable CAD and 254 with sonographically proven peripheral artery disease. Prospectively, cardiovascular events were recorded over 9.6±4.3 years. At baseline, pro-BNP was not significantly different in patients with NAFLD (n=317) than in those who did not have NAFLD (827±2360 vs. 847±2754 pg/ml; p=0.236). During follow-up, 243 patients suffered MACE and 138 cardiovascular death; event rates of MACE and cardiovascular death were significantly higher in patients with NAFLD than in subjects without NAFLD (43.9 vs. 33.2%; p=0.006 and 26.3% vs. 17.6%; p=0.008, respectively). Pro-BNP predicted MACE and cardiovascular death in the total study population, with standardized adjusted hazard ratios (HR) of 1.55 [1.40-1.71]; p<0.001 and 1.56 [1.41-1.74]; p<0.001. Further, pro-BNP predicted MACE and cardiovascular death in patients with NAFLD (HRs 1.78 [1.54-2.07]; p<0.001 and 1.80 [1.53-2.12]; p<0.001, respectively) as well as in those who did not have NAFLD (HRs 1.47 [1.28-1.68]; p<0.001 and 1.51 [1.30-1.75]; p<0.001, respectively). Interaction terms pro-BNP x NAFLD were not significant for MACE and CD (p=0.151 and p=0.197, respectively), indicating that the power of pro-BNP to predict MACE and cardiovascular death did not differ significantly between CVD patients with NAFLD and those who did not have NAFLD. We conclude that pro-BNP strongly predicts major cardiovascular events and cardiovascular death in CVD patients with NAFLD as well as in those without NAFLD. T. Plattner: None. B. Larcher: None. A. Mader: None. A. Vonbank: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None. C.H. Saely: None.