title: B-type natriuretic peptide and amino terminal proBNP predict one-year mortality in short of breath patients independently of the baseline diagnosis of acute destabilized heart failure.
abstract: BACKGROUND
  The aim of the present study was to demonstrate the capability of B-type natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP) as prognostic markers in patients with dyspnoea as a chief complaint.
  
  
  METHODS
  BNP and NT-proBNP plasma concentrations were obtained from 251 short of breath patients presenting to the emergency department of a tertiary care hospital. Patients with acute coronary syndromes or trauma were excluded. The endpoint was defined as all-cause mortality, and the study participants were followed up for 365 days from the time they attended the emergency department.
  
  
  RESULTS
  Of the 251 patients, 62 died and 189 stayed alive during follow-up. In the present study, optimal cut off levels for the prediction of survival were 454 ng/L for BNP, and 2060 ng/L for NT-proBNP. Mortality was higher in patients with baseline BNP and NT-proBNP concentrations above these cut off levels (log rank p<0.001; hazard ratios, 0.325 and 0.357, respectively). In multivariate Cox proportional-hazards regression analyses, elevated BNP/NT-proBNP, low systolic blood pressure, and renal dysfunction were predictors of mortality even when the baseline diagnosis of acute destabilized heart failure was factored into the model.
  
  
  CONCLUSIONS
  Both BNP and NT-proBNP measures obtained from short of breath patients presenting to an emergency department may be predictive of one-year all-cause mortality independently of the baseline diagnosis of acute destabilized heart failure.
authors.affiliation: Department of Internal Medicine, Konventhospital Barmherzige Brueder, Linz, Austria.
authors.forename: Alfons
authors.initials: A
authors.lastname: Gegenhuber
authors.forename: Thomas
authors.initials: T
authors.lastname: Mueller
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dieplinger
authors.forename: Werner
authors.initials: W
authors.lastname: Poelz
authors.forename: Richard
authors.initials: R
authors.lastname: Pacher
authors.forename: Meinhard
authors.initials: M
authors.lastname: Haltmayer
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D004417:Dyspnea / Q000097:blood* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D015996:Survival Rate; D013997:Time Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020097:Natriuretic Peptide, Brain