Association of NT-proBNP with non-alcoholic fatty liver disease in elderly men with normal BMI and incident heart failure

Background With the increasing burden of lean nonalcoholic fatty liver disease (NAFLD) and heart failure (HF), understanding the relationship between lean NAFLD and NT-proBNP in elderly patients becomes clinically important. This study aimed to identify the risk stratification value of combining NT-proBNP and lean NAFLD in elderly men with incident HF. Methods The data from consecutive male patients aged 80 years or older, with incident HF of New York Heart Association class III/IV and a BMI less than 23 kg/m 2 , who had available NT-proBNP measurements within 24 h of admission, were retrospectively analyzed. The clinical outcomes were 180-day all-cause and cardiovascular mortality. Results A total of 3,627 patients were included. The levels of NT-proBNP were significantly higher in patients without lean NAFLD compared to those with lean NAFLD. After multivariate logistic regression, lean NAFLD remained independently associated with NT-proBNP category. Moreover, during the 180-day follow-up, Kaplan–Meier curves confirmed that patients with both lean NAFLD and NT-proBNP > 8330pg/mL had significantly higher all-cause and cardiovascular mortality compared to those with NT-proBNP alone. Conclusion NT-proBNP levels were higher in patients without lean NAFLD than in those with lean NAFLD. The coexistence of lean NAFLD and NT-proBNP > 8330 pg/mL was associated with increased all-cause and cardiovascular mortality in elderly normal-BMI men with incident HF.