Dynamic risk stratification using serial measurements of plasma concentrations of natriuretic peptides in patients with heart failure

Zhang, J.; Pellicori, P.; Pan, D.; Dierckx, R.; Clark, A. L.; Cleland, J.G.F.

Abstract

Background
Prognostic models for patients with chronic heart failure are generally based on a single assessment but treatment is often given with the intention of changing risk; re- evaluation of risk is an important aspect of care. The prognostic value of serial measurements of natriuretic peptides for the assessment of changes in risk is uncertain.

Aims
To evaluate the prognostic value of serial measurements of plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP) during follow-up of out-patients with chronic heart failure (CHF).

Methods
Patients diagnosed with CHF between 2001 and 2014 at a single out-patient clinic serving a local community were included in this analysis. NT-proBNP was measured at the initial visit and serially during follow-up. Only patients who had one or more measurements of NT-proBNP after baseline, at 4, 12 and/or 24 months were included.

Results
At baseline, amongst 1998 patients enrolled, the median age was 73 (IQR: 64–79) years, 70% were men, 31% were in NYHA class III/IV, and 77% had NT-proBNP >400 pg/mL. Median follow-up was 4.8 (IQR 2.5–8.6) years. Serial measurements of NT-proBNP improved prediction of all-cause mortality at 3 years (c- statistic = 0.71) compared with using baseline data only (c-statistic = 0.67; p 

Citation

Zhang, J., Pellicori, P., Pan, D., Dierckx, R., Clark, A. L., & Cleland, J. (2018). Dynamic risk stratification using serial measurements of plasma concentrations of natriuretic peptides in patients with heart failure. International journal of cardiology, 269, 196-200. https://doi.org/10.1016/j.ijcard.2018.06.070

• Journal Article Type: Article
• Acceptance Date: Jun 18, 2018
• Online Publication Date: Jun 25, 2018
• Publication Date: Oct 15, 2018
• Deposit Date: Jul 3, 2018
• Publicly Available Date: Jun 26, 2019
• Print ISSN: 0167-5273
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 269
• Pages: 196-200
• DOI: https://doi.org/10.1016/j.ijcard.2018.06.070
• Keywords: Repeated NT-proBNP; Mortality and chronic heart failure
• Public URL: https://hull-repository.worktribe.com/output/908718
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0167527317374296#!
• Additional Information: This is the accepted manuscript of an article published in International journal of cardiology, 2018. The version of record is available at the DOI link in this record.
• Contract Date: Jul 4, 2018