B-type natriuretic peptide is associated with mortality in older functionally impaired patients.
OBJECTIVE
To determine the predictive power of B-type natriuretic peptide (BNP) regarding death in older, functionally impaired patients with multiple comorbidity.


METHODS
Prospective cohort study.


METHODS
Specialist geriatric assessment clinic and day hospital.


METHODS
Two hundred ninety-nine older, functionally impaired patients, mean age 79 at enrollment.


METHODS
Full clinical history and examination, baseline BNP, and echocardiography. Date and cause of death were ascertained from Scottish death records. Kaplan-Meier survival curves were constructed for quartiles of log (BNP), and the contribution of BNP to prediction of death was investigated.


RESULTS
The follow-up period ranged from 3.9 to 5.2 years (mean 4.4 years). BNP was a powerful independent predictor of all-cause and cardiovascular mortality. BNP was a more powerful predictor than blood pressure, diabetes mellitus, smoking, echocardiographic left ventricular hypertrophy, left ventricular systolic dysfunction, or age. BNP predicted death in those with and without a previous cardiovascular event at baseline.


CONCLUSIONS
BNP has significant predictive power for death in older, functionally impaired patients.
Witham
Miles D
MD
Section of Aging and Health, University of Dundee, Ninewells Hospital, Dundee, Scotland. m.witham@dundee.ac.uk
Gillespie
Neil D
ND
Hutcheon
Stuart D
SD
Struthers
Allan D
AD
McMurdo
Marion E T
ME
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002908:Chronic Disease / Q000401:mortality*; D015331:Cohort Studies; D006233:Persons with Disabilities; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011863:Radioimmunoassay; D012606:Scotland; D016019:Survival Analysis
D020097:Natriuretic Peptide, Brain