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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

Authors

L. Frankenstein

J. G. F. Cleland

A. L. Clark

K. Goode K.M.Goode@hull.ac.uk

A. Remppis

D. Schellberg

F. Grabs

M. Nelles

J. G. F. Cleland

H. A. Katus

C. Zugck

A L Clark A.L.Clark@hull.ac.uk

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.

Journal Article Type Article
Publication Date May 1, 2009
Journal HEART
Print ISSN 1355-6037
Electronic ISSN 1468-201X
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 95
Issue 10
Pages 825-829
Institution Citation Frankenstein, L., Clark, A. L., Goode, K., Ingle, L., Remppis, A., Schellberg, D., …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
DOI https://doi.org/10.1136/hrt.2008.158626
Keywords Cardiology and Cardiovascular Medicine