Predictors of elevated NT-pro-BNP in cardiovascular patients without acute heart failure.
OBJECTIVE
B-type natriuretic peptides are recommended for evaluation of acute heart failure. Aim of this study was to identify predictors of pathologically elevated NT-pro-BNP in patients without acute heart failure.


METHODS
NT-pro-BNP was measured in 486 inpatients with cardiovascular disease and the association with clinical and laboratory parameters was examined. Elevated NT-pro-BNP was defined according to rule-in cut-off values for acute heart failure: 450 pg/ml for age <50 years, 900 pg/ml for 50-75 years and 1800 pg/ml for >75 years.


RESULTS
Multivariate analysis of variables assessable without echocardiography revealed fibrinogen, albumin, atrial fibrillation, history of heart failure and diuretic use as independent predictors of pathological NT-pro-BNP. The odds for pathological NT-pro-BNP were 2.5, 8.8, 27 and 41 in the presence of 1, 2, 3 and 4/5 predictors, respectively. After adjusting for cardiac dysfunction, fibrinogen, albumin, history of heart failure and atrial fibrillation still remained significant.


CONCLUSIONS
Assessment of these parameters could help avoid wrong positive interpretation of NT-pro-BNP results.
Pfister
Roman
R
Tan
Dajana
D
Thekkanal
Jaimy
J
Hellmich
Martin
M
Schneider
Chistian Alfons
CA
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain