title: Prognostic value of high plasma brain natriuretic peptide concentrations in very elderly persons.
abstract: BACKGROUND
  Many elderly persons without heart failure have high plasma concentrations of brain natriuretic peptide (BNP). We investigated the prognostic implications and potential causes of these increased levels.
  
  
  METHODS
  We enrolled 111 persons aged 80 years or older who had no history of hospitalization for cardiac disease, a cardiothoracic ratio < or =55% on chest radiographs, and a serum creatinine level < or =2.0 mg/mL. All subjects had participated in a regular health screening program at our hospital, and were followed for up to 24 months. We studied the correlation of plasma BNP concentration with age, nutritional state, and activities of daily living. Cox proportional hazards models were used to determine the association between BNP levels and clinical outcomes (cardiac hospitalizations, mortality), adjusted for other risk factors.
  
  
  RESULTS
  During follow-up, 8 subjects (7%) were hospitalized with cardiac disorders, and 21 (19%) died. Each 50-pg/mL increase in the plasma BNP concentration was associated with a 1.6-fold increase in the risk of cardiac events (95% confidence interval [CI]: 1.2 to 2.1) and a 1.4-fold increase in total mortality (95% CI: 1.2 to 1.6). Plasma BNP concentration correlated positively with age (r = 0.31, P = 0.001), serum creatinine level (r = 0.23, P = 0.02), and the activities of daily living (r = 0.36, P = 0.0001).
  
  
  CONCLUSIONS
  In very elderly persons, the plasma BNP concentration may be a biochemical marker of an increased risk of cardiac morbidity and total mortality.
authors.affiliation: Department of Internal Medicine, Yokufukai Geriatric Hospital, 1-12-1 Takaido-Nishi, Suginami-ku, Tokyo, Japan. ueryu@dh.catv.ne.jp
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ueda
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Yokouchi
authors.forename: Takaomi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Eiichi
authors.initials: E
authors.lastname: Otomo
authors.forename: Takashi
authors.initials: T
authors.lastname: Katagiri
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000378:metabolism*; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain