High NT-proBNP is a strong predictor of outcome in elderly heart failure patients.
All patients older than 65 years (184 men; mean age, 78+/-0.8 years/181 women; mean age, 82+/-0.6 years) seeking medical attention at the Lund University Hospital Emergency Clinic during a 2-year period who had an N-terminal prohormone brain natriuretic peptide (NT-proBNP) value >2000 pg/mL were followed up for survival. Mortality in the entire population was 21% after 3 months, 35% after 1 year, and 40% after 2 years. Multivariate analysis indicated that the NT-proBNP level and the New York Heart Association (NYHA) functional class were stronger predictors of mortality than were echocardiographic estimation of left ventricular ejection fraction or chest radiography. Patients who survived the first year were younger, had higher systolic blood pressure, had lower plasma creatinine, had lower inflammatory activity, and were treated with lower doses of furosemide. The results indicate that in this population, NT-proBNP level together with assessment of NYHA class gives the best prognostic information of 1-year mortality.
Andersson
Sven E
SE
Department of Emergency Medicine, Institute of Clinical Science, Lund University Hospital, Lund, Sweden. sven.ea@telia.com
Edvinsson
Marie-Louise
ML
Björk
Jonas
J
Edvinsson
Lars
L
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006304:Health Status; D006305:Health Status Indicators; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D011379:Prognosis; D011446:Prospective Studies; D018434:Sickness Impact Profile; D016896:Treatment Outcome
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D005665:Furosemide