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Article ; Online: NT-proBNP is superior to BNP for predicting first cardiovascular events in the general population: the Heinz Nixdorf Recall Study.

Kara, Kaffer / Lehmann, Nils / Neumann, Till / Kälsch, Hagen / Möhlenkamp, Stefan / Dykun, Iryna / Broecker-Preuss, Martina / Pundt, Noreen / Moebus, Susanne / Jöckel, Karl-Heinz / Erbel, Raimund / Mahabadi, Amir A

International journal of cardiology

2015 Volume 183, Page(s) 155–161

Abstract: ... both peptides for their prognostic value is lacking.: Methods: Participants from the population-based Heinz ...

Abstract	Background: B-type natriuretic peptide (BNP) as well as N-terminal-proBNP (NT-proBNP) are associated with cardiac events in the general population. Yet, data from the general population comparing both peptides for their prognostic value is lacking. Methods: Participants from the population-based Heinz-Nixdorf-Recall-study without cardiovascular diseases were included. Associations of BNP and NT-proBNP with incident cardiovascular events (incident myocardial infarction, stroke, or cardiovascular death) were assessed using Cox regression; prognostic value was addressed using Harrell's c statistic. Results: From overall 3589 subjects (mean age: 59.3 ± 7.7 yrs, 52.5% female), 235 subjects developed a cardiovascular event during 8.9 ± 2.2 yrs of follow-up. In regression analysis both natriuretic peptides were associated with incident cardiovascular events, independent of traditional risk factors (hazard ratio (HR) per unit increase on log-scale (95% CI): NT-proBNP: 1.60 (1.39; 1.84); BNP: 1.37 (1.19; 1.58), p<0.0001 respectively). Specifically looking at subjects <60 yrs only NT-proBNP, was linked with events (HR (95% CI): 1.59 (1.19; 2.13) for NT-proBNP, p=0.0019; HR: 1.25 (0.94; 1.65) for BNP, p=0.12, after adjustment for age and gender). Similar results were observed for females (HR (95% CI) 1.65 (1.28; 2.12), p=0.0001 for NT-proBNP, and 1.24 (0.96; 1.61), p=0.10 for BNP after adjustment for age). Adding NT-proBNP/BNP to traditional risk factors increased the prognostic value, with effects being stronger for NT-proBNP (Harrell's c, 0.724 to 0.741, p=0.034) as compared to BNP (0.724 to 0.732, p=0.20). Conclusion: Both, NT-proBNP and BNP are associated with future cardiovascular events in the general population. However, when both are available, NT-proBNP seems to be superior due to its higher prognostic value, especially in younger subjects and females.
MeSH term(s)	Aged ; Biomarkers/metabolism ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/metabolism ; Cohort Studies ; Female ; Germany/epidemiology ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain/metabolism ; Peptide Fragments/metabolism ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Assessment ; Risk Factors
Chemical Substances	Biomarkers ; Peptide Fragments ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2015-03-15
Publishing country	Netherlands
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2015.01.082
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Article ; Online: B-type natriuretic peptide for incident atrial fibrillation-The Heinz Nixdorf Recall Study.

Kara, Kaffer / Geisel, Marie Henrike / Möhlenkamp, Stefan / Lehmann, Nils / Kälsch, Hagen / Bauer, Marcus / Neumann, Till / Dragano, Nico / Moebus, Susanne / Jöckel, Karl-Heinz / Erbel, Raimund / Mahabadi, Amir Abbas

Journal of cardiology

2015 Volume 65, Issue 6, Page(s) 453–458

Abstract: ... Methods: We included subjects from the population-based Heinz Nixdorf Recall study without known ...

Abstract	Background: Atrial fibrillation (AF) is the most common arrhythmia and is associated with increased morbidity and mortality. Thus, identifying subjects with unknown AF or at higher risk for future AF in the general population is of importance. B-type natriuretic peptide (BNP) is linked with silent cardiac diseases. We evaluated the association of BNP with incident AF in a large population-based cohort study. Methods: We included subjects from the population-based Heinz Nixdorf Recall study without known coronary heart disease, prior stroke, history of open heart surgery, heart-device therapy, or prevalent AF at baseline. Association of continuous and binary (≥31pg/ml for male, ≥45pg/ml for female) BNP with incident AF after 5 years was assessed using logistic regression analysis. Results: A total of 3067 subjects (mean age 58.9 years, 47.9% male) were included in this analysis. Subjects with incident AF (n=42) had higher levels of BNP (median (Q1; Q3): 33.2pg/ml (19.4; 50.5) vs. 16.9pg/ml (9.2; 30.2)). Likewise, BNP was associated with incidence of AF both in univariate model and when adjusting for AF risk factors (odds ratio (OR) (95% confidence interval (CI)): BNP as continuous variable: 1.27 (1.09; 1.47), p=0.002; BNP as binary variable: 2.68 (1.41; 5.11) with AF risk factor adjustment). Notably, especially younger subjects (<60 years) showed stronger association with incident AF than older ones (OR (95%CI) for dichotomized BNP: 7.20 (1.60; 32.49), p=0.01 for <60 years, vs. 2.13 (0.89; 5.09), p=0.09 for 60-70 years, and 4.40 (1.29; 14.97), p=0.02 for >70 years). Conclusions: Elevated levels of BNP are associated with significant excess of incident AF, independent of traditional AF risk factors in the general population. Gender-specific BNP thresholds may help in prevention by detecting unknown or future AF, which carries a high risk of stroke events.
MeSH term(s)	Age Factors ; Aged ; Atrial Fibrillation/blood ; Atrial Fibrillation/epidemiology ; Biomarkers/blood ; Cohort Studies ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Odds Ratio ; Risk Factors ; Sex Factors
Chemical Substances	Biomarkers ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2015-06
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639364-0
ISSN	1876-4738 ; 0386-2887 ; 0914-5087
ISSN (online)	1876-4738
ISSN	0386-2887 ; 0914-5087
DOI	10.1016/j.jjcc.2014.08.003
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Zs.A 1794: Show issues

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Article: Interview mit Heinz-Dieter Neumann zur Manuellen Medizin

Neumann, Heinz-Dieter

Osteopathische Medizin

2008 Volume 9, Issue 2, Page(s) 9

Language	German
Document type	Article
ZDB-ID	2041875-9
ISSN	1615-9071
Database	Current Contents Medicine

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Zs.A 5417: Show issues

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Article ; Online: B-type natriuretic peptide: distribution in the general population and the association with major cardiovascular and coronary events--the Heinz Nixdorf Recall Study.

Kara, Kaffer / Mahabadi, Amir A / Geisel, Marie H / Lehmann, Nils / Kälsch, Hagen / Bauer, Marcus / Neumann, Till / Dragano, Nico / Moebus, Susanne / Möhlenkamp, Stefan / Jöckel, Karl-Heinz / Erbel, Raimund

Clinical research in cardiology : official journal of the German Cardiac Society

2013 Volume 103, Issue 2, Page(s) 125–132

Abstract: Background: A B-type natriuretic peptide (BNP) threshold of 100 pg/ml is used in practice for identification of heart failure, but data about the "normal" distribution of BNP in a large population in primary prevention are rare. We aimed to characterize ...

Abstract	Background: A B-type natriuretic peptide (BNP) threshold of 100 pg/ml is used in practice for identification of heart failure, but data about the "normal" distribution of BNP in a large population in primary prevention are rare. We aimed to characterize the BNP distribution in a healthy subset of a population-based cohort and to evaluate the association of elevated BNP levels with major events. Methods: In a first step, we determined gender-specific distribution and 90th percentiles of BNP in participants who were at baseline free from known determinants of increased BNP, i.e. cardiovascular disease, hypertension or chronic kidney disease. Consecutively, the association of BNP levels above these 90th percentiles with subsequent cardiovascular and coronary events was assessed in the entire cohort. Results: In the BNP-normal sub-sample (n = 1,639), we defined gender-specific 90th percentile of BNP (31.3 pg/ml for men, 45.5 pg/ml for women). From overall 3,697 subjects (mean age 59.4, 52.4 % female), 194 subjects developed a major cardiovascular event and 122 myocardial infarction during a mean follow-up period of 8.0 ± 1.5 years. The 90th percentiles derived from the normal subset as threshold showed strong associations with major events in the entire cohort even after adjusting for traditional risk factors: hazard ratio (95% CI): 1.86 (1.37; 2.53), p < 0.0001 for cardiovascular, and 1.77 (1.19; 2.62), p = 0.005 for coronary events. Conclusion: The gender-specific 90th percentile of BNP (31 pg/ml for males and 45 pg/ml for females) obtained from a BNP-normal sub-sample is associated with incident major cardiovascular and coronary events, suggesting that even BNP values lower than 100 pg/ml could imply prognostic information in the general population.
MeSH term(s)	Adult ; Age Distribution ; Age Factors ; Aged ; Biomarkers/blood ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/diagnosis ; Female ; Germany ; Humans ; Male ; Middle Aged ; Myocardial Infarction/blood ; Myocardial Infarction/diagnosis ; Natriuretic Peptide, Brain/blood ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Reference Values ; Sex Distribution ; Sex Factors
Chemical Substances	Biomarkers ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2013-10-15
Publishing country	Germany
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-013-0628-4
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Article ; Online: Predicting risk of coronary events and all-cause mortality: role of B-type natriuretic peptide above traditional risk factors and coronary artery calcium scoring in the general population: the Heinz Nixdorf Recall Study.

Kara, Kaffer / Mahabadi, Amir A / Berg, Marie H / Lehmann, Nils / Möhlenkamp, Stefan / Kälsch, Hagen / Bauer, Marcus / Moebus, Susanne / Dragano, Nico / Jöckel, Karl-Heinz / Neumann, Till / Erbel, Raimund

European journal of preventive cardiology

2014 Volume 21, Issue 9, Page(s) 1171–1179

Abstract: ... participants of the population-based Heinz Nixdorf Recall cohort study without coronary artery disease ...

Abstract	Aims: Several biomarkers including B-type natriuretic peptide (BNP) have been suggested to improve prediction of coronary events and all-cause mortality. Moreover, coronary artery calcium (CAC) as marker of subclinical atherosclerosis is a strong predictor for cardiovascular mortality and morbidity. We aimed to evaluate the predictive ability of BNP and CAC for all-cause mortality and coronary events above traditional cardiovascular risk factors (TRF) in the general population. Methods: We followed 3782 participants of the population-based Heinz Nixdorf Recall cohort study without coronary artery disease at baseline for 7.3 ± 1.3 years. Associations of BNP and CAC with incident coronary events and all-cause mortality were assessed using Cox regression, Harrell's c, and time-dependent integrated discrimination improvement (IDI(t), increase in explained variance). Results: Subjects with high BNP levels had increased frequency of coronary events and death (coronary events/mortality: 14.1/28.2% for BNP ≥100 pg/ml vs. 2.7/5.5% for BNP < 100 pg/ml, respectively). Subjects with a BNP ≥100 pg/ml had increased incidence of hard endpoints sustaining adjustment for CAC and TRF (for coronary events: hazard ratio (HR) (95% confidence interval (CI)) 3.41(1.78-6.53); for all-cause mortality: HR 3.35(2.15-5.23)). Adding BNP to TRF and CAC increased measures of predictive ability: coronary events (Harrell's c, for coronary events, 0.775-0.784, p = 0.09; for all-cause mortality 0.733-0.740, p = 0.04; and IDI(t) (95% CI), for coronary events: 2.79% (0.33-5.65%) and for all-cause mortality 1.78% (0.73-3.10%). Conclusions: Elevated levels of BNP are associated with excess incident coronary events and all-cause mortality rates, with BNP and CAC significantly and complementary improving prediction of risk in the general population above TRF.
MeSH term(s)	Aged ; Biomarkers/blood ; Calcinosis/blood ; Calcinosis/diagnostic imaging ; Calcinosis/epidemiology ; Cause of Death/trends ; Coronary Angiography ; Coronary Artery Disease/blood ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Female ; Follow-Up Studies ; Germany/epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Population Surveillance/methods ; Predictive Value of Tests ; Prospective Studies ; Risk Assessment ; Risk Factors ; Tomography, X-Ray Computed
Chemical Substances	Biomarkers ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2014-09
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2626011-6
ISSN	2047-4881 ; 2047-4873
ISSN (online)	2047-4881
ISSN	2047-4873
DOI	10.1177/2047487313490256
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Zs.A 4686: Show issues

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Article: Analyse des natürlichen Verlaufs der Koronargefässverkalkung und Identifizierung ihrer Determinanten. Rationale des 2. Teils der Heinz Nixdorf Recall Studie.

Möhlenkamp, Stefan / Moebus, Susanne / Schmermund, Axel / Lehmann, Nils / Hoffmann, Barbara / Neumann, Till / Stang, Andreas / Dragano, Nico / Kerkhoff, Gert / Naber, Christoph / Kälsch, Hagen / Beck, Eva-Maria / Bröcker-Preuss, Martina / Kröger, Knut / Budde, Thomas / Siegrist, Johannes / Mann, Klaus / Jöckel, Karl-Heinz / Erbel, Raimund

Herz

2007 Volume 32, Issue 2, Page(s) 108–120

Abstract: The Heinz Nixdorf Recall Study, which was inaugurated in 2000, is an ongoing population-based study ... measurements. In the Heinz Nixdorf Recall Study, the impact of established and new risk factors, e.g ... The Heinz Nixdorf Recall Study will contribute to the appraisal of new imaging modalities in risk ...

Title translation	Assessment of the natural history of coronary artery calcification and identification of its determinants. Rationale of the 2nd part of the Heinz Nixdorf Recall Study.
Abstract	The Heinz Nixdorf Recall Study, which was inaugurated in 2000, is an ongoing population-based study to evaluate the prediction of cardiovascular events by integrating new imaging and nonimaging modalities in risk assessment. A focus is the additional prognostic value of coronary artery calcification (CAC). Currently used risk stratification algorithms often describe the individuals' risk based on few established risk factors only inaccurately. Using noninvasive quantification of CAC progression, the natural history of atherosclerosis with its repetitive, frequently subclinical plaque ruptures, may detect an unstable course of the disease long before the disease irreversibly manifests in sudden death or myocardial infarction. While the independent additional prognostic value of CAC quantification has been shown in asymptomatic patients at intermediate risk, only few studies provided evidence for an independent prognostic value of serial CAC measurements. In the Heinz Nixdorf Recall Study, the impact of established and new risk factors, e.g., the metabolic syndrome, psychosocial and environmental risk factors, or genetic variables, can be assessed. Further, the association of CAC progression with the incidence of other cardiovascular diseases such as heart failure or aortic or aortic valve calcification can be described. Since April 2006, the participants of the study return to the study center 5 years after baseline recruitment to assess health status and to determine the risk factor profile. Based on recently published data, serial CAC measurements have been granted allowing for (1) characterization of the natural history of CAC progression, and (2) identification of its determinants. The rationale of serial CAC quantification is discussed in this article.The Heinz Nixdorf Recall Study will contribute to the appraisal of new imaging modalities in risk stratification.
MeSH term(s)	Aged ; Calcinosis/diagnosis ; Calcinosis/epidemiology ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/epidemiology ; Data Collection ; Disease Progression ; Female ; Germany/epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Prognosis ; Risk Assessment/methods ; Risk Factors
Language	German
Publishing date	2007-03
Publishing country	Germany
Document type	English Abstract ; Journal Article
ZDB-ID	8262-4
ISSN	1615-6692 ; 0340-9937 ; 0946-1299
ISSN (online)	1615-6692
ISSN	0340-9937 ; 0946-1299
DOI	10.1007/s00059-007-2982-3
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Zs.A 1270: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Association of coronary artery calcium and congestive heart failure in the general population: Results of the Heinz Nixdorf Recall study.

Kälsch, H / Lehmann, N / Möhlenkamp, S / Neumann, T / Slomiany, U / Schmermund, Axel / Stang, Andreas / Moebus, S / Bauer, M / Mann, K / Jöckel, K-H / Erbel, R

Clinical research in cardiology : official journal of the German Cardiac Society

2010 Volume 99, Issue 3, Page(s) 175–182

Abstract: ... of subclinical CAD and CHF in a general unselected population.: Methods: Participants of the Heinz Nixdorf ...

Abstract	Background: The main causes of congestive heart failure (CHF) are coronary artery disease (CAD) and arterial hypertension. Coronary artery calcification (CAC) evidencing coronary atherosclerosis may occur prior to clinical CAD. The aim of our study was to assess the association between CAC as a sign of subclinical CAD and CHF in a general unselected population. Methods: Participants of the Heinz Nixdorf Recall Study without known CAD but with known CHF as defined by a physicians' diagnosis of CHF and dyspnea were identified. B-natriuretic peptide was measured and an exercise stress test was performed as possible. Cardiovascular risk factors and the EBCT-based CAC Agatston score were determined. Results: Those 105/4,230 subjects (2.5%) with CHF (age 65 +/- 7 years, 44% males), had higher brain natriuretic peptide (BNP) levels (median BNP 36.8 [16.5-70.1] vs. 17.6 [9.5-31.7] pg/ml, p<0.01) and lower exercise capacity (108.7 +/- 39.4 vs. 130.0 +/- 40.7 W, p<0.01) than those without. CAC in subjects with CHF was significantly higher than in those without (median CAC 64.7 [8.5-312.3] vs. 11.6 [0-109.8], p<0.01). In univariate analysis, CAC-burden after logarithmic transformation according to log(2)(CAC + 1) showed a significant association with the presence of CHF (odds ratio (OR) (95% CI): 1.16 (1.1-1.23), p<0.0001). Adjustment for age and sex (OR 1.11 (1.04-1.18), p<0.001), additional Framingham risk score (OR 1.09 (1.02-1.16), p = 0.015), and additional cardiovascular medication (OR 1.07 (0.998-1.14), p = 0.058) attenuated this association. Age, systolic blood pressure, antihypertensive medication and increased body mass index also remained significantly associated with presence of CHF in the full multivariate model. Conclusion: The observed association between CAC and CHF in persons without clinically overt CAD is partly determined by risk factors that are involved in the natural history of both CAC and CHF. Whether CAC has a role to identify subjects at risk of future CHF remains to be determined using follow-up analyses.
MeSH term(s)	Aged ; Calcinosis/complications ; Calcium/metabolism ; Cohort Studies ; Coronary Artery Disease/complications ; Coronary Artery Disease/physiopathology ; Coronary Vessels/pathology ; Exercise Test ; Female ; Heart Failure/etiology ; Humans ; Hypertension/complications ; Male ; Middle Aged ; Multivariate Analysis ; Natriuretic Peptide, Brain/metabolism ; Prospective Studies ; Risk Factors
Chemical Substances	Natriuretic Peptide, Brain (114471-18-0) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2010-01-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-009-0104-3
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Article: Interview with Professor Karl-Heinz Mehlan.

Neumann, H G

Planned parenthood in Europe = Planning familial en Europe

1991 Volume 20, Issue 2, Page(s) 26–27

MeSH term(s)	Abortion, Induced ; Abortion, Legal ; Ambulatory Care Facilities ; Delivery of Health Care ; Europe ; Europe, Eastern ; Family Planning Services ; Germany, East ; Health ; Health Facilities ; Health Planning ; Organization and Administration
Language	English
Publishing date	1991-09
Publishing country	England
Document type	Journal Article
ISSN	1017-8538
ISSN	1017-8538
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Book: "Niemand hat das Recht, sein Talent zu vergeuden" Heinz Maier-Leibnitz

Noelle-Neumann, Elisabeth

ein Porträt in Zitaten

(Texte + Thesen ; 280)

2001

Author's details	Elisabeth Noelle-Neumann (Hrsg.)
Series title	Texte + Thesen ; 280
Language	German
Size	160 S, Ill, 19 cm
Edition	Orig.-Ausg
Publisher	Fromm ; Ed. Interfrom
Publishing place	Osnabrück ; Zürich
Document type	Book
Note	Bibliogr. H. Maier Leibnitz S. 139 - 160
ISBN	3720152804 ; 9783720152808
Database	Former special subject collection: coastal and deep sea fishing

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Article: Association of coronary artery calcium and congestive heart failure in the general population: results of the Heinz Nixdorf Recall Study

Kälsch, H. / Lehmann, N. / Möhlenkamp, S. / Neumann, T. / Slomiany, U. / Schmermund, A. / Stang, A. / Moebus, S. / Bauer, M. / Mann, K. / Jöckel, K.-H. / Erbel, R.

Clinical research in cardiology

2010 Volume 99, Issue 3, Page(s) 175

Language	English
Document type	Article
ZDB-ID	2213295-8
ISSN	1861-0684
Database	Current Contents Medicine

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