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

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


J. Zhang

Marilyn Etheridge

P. Pellicori

D. Pan

R. Dierckx

A. L. Clark

J.G.F. Cleland


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.

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).

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.

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 


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.

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
Electronic ISSN 1874-1754
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 269
Pages 196-200
Keywords Repeated NT-proBNP; Mortality and chronic heart failure
Public URL
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Copyright Statement ©2018, Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
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.


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