Exploring the relation between changes in NT-proBNP and renal function in patients with suspected heart failure using structural equation modelling

Zhang, Jufen; Wong, Kenneth; Clark, Andrew L.; Cleland, John G.F.

Abstract

Background The relation between changes in NT-proBNP and renal function has commonly been studied using multiple regressions, which may ignore the complexity of relations between related variables. Methods and results Data were collected from patients referred with suspected heart failure (HF) to a community service. Structural equation modelling (SEM) was used to assess the association between changes in NT-proBNP at 1 year, and other pre-specified variables including age, sex, BMI, eGFR, loop diuretics and ACE inhibitor. Of 1006 patients with a follow-up NT-proBNP at 1 year, 882 (88%) had HF. The baseline median age was 72 (IQR: 63–78) years, 732 (73%) were men, 668 (66%) had left ventricular systolic dysfunction and 769 (76%) had NT-proBNP > 400 pg/ml. For all patients at 1 year, 243 (24%) patients had at least a 50% reduction in NT-proBNP, and 199 (20%) had at least a 50% increase, only 40 (3%) had < 3% change. Change in NT-proBNP was strongly associated with baseline NT-proBNP (the standardized coefficient (r) = 0.73, p < 0.001). The change in NT-proBNP was not associated with changes in eGFR, and was indirectly related with age, BMI, eGFR and loop diuretics (p < 0.01 for all). Conclusions Baseline NT-proBNP was the main determinant of change in NT-proBNP at one year.

Citation

Zhang, J., Wong, K., Clark, A. L., & Cleland, J. G. (2017). Exploring the relation between changes in NT-proBNP and renal function in patients with suspected heart failure using structural equation modelling. International journal of cardiology, 233, 67-72. https://doi.org/10.1016/j.ijcard.2017.01.127

• Acceptance Date: Jan 26, 2017
• Online Publication Date: Jan 27, 2017
• Publication Date: Apr 15, 2017
• Deposit Date: Feb 15, 2017
• Publicly Available Date: Feb 1, 2018
• Journal: International journal of cardiology
• Print ISSN: 0167-5273
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 233
• Pages: 67-72
• DOI: https://doi.org/10.1016/j.ijcard.2017.01.127
• Keywords: Change in NT-proBNP; Renal function; Suspected heart failure
• Public URL: https://hull-repository.worktribe.com/output/448370
• Publisher URL: http://www.sciencedirect.com/science/article/pii/S0167527317305570
• Additional Information: Authors' accepted manuscript of article published in: International journal of cardiology, 2017, v.233.
• Contract Date: Feb 1, 2018