title: [Serum NT-proBNP levels are a prognostic predictor in patients with advanced heart failure].
abstract: OBJECTIVE
  To verify if the determination of NT-proBNP values would help predict the prognosis in advanced heart failure (HF) patients.
  
  
  METHODS
  One hundred and five subjects with average age of 52.4 years were evaluated, 66.6% of them males. Thirty-three (32.0%) subjects were outpatients and 70 (67.9%) were inpatients (functional class III/IV) admitted to the hospital for cardiac compensation. All patients had left ventricular systolic dysfunction and a mean ejection fraction of 0.29. The NT-proBNP levels were measured in all patients and they were followed-up over a period from 2 to 90 days (average 77 days). A ROC curve was drawn to determine the best cut-off point, as well as the corresponding Kaplan-Meyer survival curves.
  
  
  RESULTS
  During the follow-up period, 22 patients died. The average NT-proBNP value of the patients who remained alive was 6,443.67+/-6,071.62 pg/ml, whereas that of those who died was 14,609.66+/-12,165.15 pg/ml (p=0.001). The ROC curve identified a cut-off point at 6,000 pg/ml with 77.3% sensitivity (area under the curve: 0.74). The survival curve for values below and above 6,000 pg/ml was significantly different (p=0.002): patients with values below 6,000 pg/ml had a 90.2% 90-day survival, and those patients with values above, a 66% survival.
  
  
  CONCLUSIONS
  Patients with advanced HF, especially those admitted to the hospital for cardiac compensation, had much higher NT-proBNP values, with a two-fold increase among those who died during the follow-up period. Values above 6,000 pg/ml identify the patients most likely to die within 90 days after hospital discharge.
authors.affiliation: Instituto do Coração do Hospital das Clínicas, FMUSP, São Paulo, SP. pereira.barretto@incor.usp.br
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Pereira-Barretto
authors.forename: Mucio Tavares
authors.initials: MT
authors.lastname: de Oliveira
authors.forename: Célia Cassaro
authors.initials: CC
authors.lastname: Strunz
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Del Carlo
authors.forename: Airton Roberto
authors.initials: AR
authors.lastname: Scipioni
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain