The prognostic value of individual NT-proBNP values in chronic heart failure does not change with advancing age

Frankenstein, L.; Cleland, J. G. F.; Clark, A. L.; Goode, K.; Ingle, L.; Remppis, A.; Schellberg, D.; Grabs, F.; Nelles, M.; Cleland, J. G. F.; Katus, H. A.; Zugck, C.; Clark, A L; Ingle, L

Abstract

Background: It is unclear whether age-related increases in N-terminal pro-brain natriuretic peptide (NT-proBNP) represent a normal physiological process - possibly affecting the prognostic power - of NT-proBNP - or reflect age-related subclinical pathological changes. Objective: To determine the effect of age on the short-term prognostic value of NT-proBNP in patients with chronic heart failure (CHF). Design: Prospective observational study with inclusion and matching of consecutive patients aged > 65 years (mean (SD) 73.1 (6.0) years) to patients < 65 years (53.7 (8.6) years) with respect to NT-proBNP, New York Heart Association stage, sex and aetiology of CHF (final n = 443). Setting: University hospital outpatient departments in the UK and Germany. Patients: Chronic stable heart failure due to systolic left ventricular dysfunction. Intervention: None. Outcome measure: All-cause mortality. Results: In both age groups, NT-proBNP was a significant univariate predictor of mortality, a nd independent of age, sex and other established risk markers. The prognostic information given by NT-proBNP was comparable between the two groups, as reflected by the 1-year mortality of 9% in both groups. The prognostic accuracy of NT-proBNP as judged by the area under the receiver operating characteristics curve for the prediction of 1-year mortality was comparable for elderly and younger patients (0.67 vs 0.71; p = 0.09). Conclusion: NT-proBNP reflects disease severity in elderly and younger patients alike. In patients with chronic stable heart failure, the NT-proBNP value carries the same 1-year prognostic information regardless of the age of the patient.

Citation

Frankenstein, L., Clark, A. L., Goode, K., Ingle, L., Remppis, A., Schellberg, D., Grabs, F., Nelles, M., Cleland, J. G. F., Katus, H. A., & Zugck, C. (2009). The prognostic value of individual NT-proBNP values in chronic heart failure does not change with advancing age. Heart, 95(10), 825-829. https://doi.org/10.1136/hrt.2008.158626

• Journal Article Type: Article
• Acceptance Date: May 31, 2009
• Online Publication Date: Jan 15, 2009
• Publication Date: May 1, 2009
• Journal: HEART
• Print ISSN: 1355-6037
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 95
• Issue: 10
• Pages: 825-829
• DOI: https://doi.org/10.1136/hrt.2008.158626
• Keywords: Cardiology and Cardiovascular Medicine
• Public URL: https://hull-repository.worktribe.com/output/387082