Usefulness of in-hospital change in B-type natriuretic peptide levels in predicting long-term outcome in elderly patients admitted for decompensated heart failure.
The usefulness of repeated measures of B-type natriuretic peptide (BNP) in elderly subjects with decompensated heart failure to improve risk stratification remains poorly known. This prospective cohort study included 61 consecutive patients older than 70 years (mean age, 82.7 years) hospitalized for decompensated heart failure. Clinical, radiologic, biologic, and echographic data were collected at admission and at discharge. The median BNP level at admission was 1136 pg/mL and the mean change during the hospitalization was -32%. Cardiac death or readmission were best predicted by the change in BNP levels, with the poorest prognosis in patients who did not achieve a decrease of at least 40% (hazard ratio, 4.03; 95% confidence interval, 1.50-10.84 in multivariate analysis). Admission of an elderly patient for decompensated heart failure is a daily situation in clinical practice, in which 2 BNP measurements seem to provide reliable information on long-term prognosis.
Cournot
Maxime
M
Cardiovascular Epidemiology Unit, INSERM U558, Toulouse, France. cournot@cict.fr
Leprince
Philippe
P
Destrac
Sylvain
S
Ferrières
Jean
J
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D020097:Natriuretic Peptide, Brain