Prognostic impact of NT-proBNP and renal function in comparison to contemporary multi-marker risk scores in heart failure patients.
BACKGROUND
Multi-marker risk scores accurately predict prognosis in heart failure patients but calculation is complex.


OBJECTIVE
To compare the prognostic accuracy of the Seattle Heart Failure Survival Score (SHFS) and a model derived from the CHARM programme, with laboratory parameters NT-proBNP and glomerular filtration rate (GFR).


RESULTS
In a sample of 290 heart failure patients, 39 patients died, 22 were hospitalised with acute heart failure and 4 underwent urgent cardiac transplantation during a median follow-up of 498 days. NT-proBNP, GFR, CHARM and SHFS showed an AUC for an endpoint during 1-year of 0.80, 0.72, 0.79 and 0.69, respectively. The hazard ratio for an endpoint during follow-up was 2.1, 2.6, 1.9 and 2.1 per 1 SD increase of log NT-proBNP and CHARM and per 1 SD decrease of GFR and SHFS, respectively. In multivariate analysis, log NT-proBNP and GFR added independent prognostic information to CHARM and SHFS, respectively.


CONCLUSIONS
NT-proBNP and GFR independently predicted endpoint-free survival in systolic heart failure patients, with NT-proBNP being superior and equally predictive to the SHFS and CHARM score, respectively. Assessment of both laboratory markers can simplify prognostic stratification, addition to multi-marker scores should be evaluated.
Pfister
Roman
R
Department III of Internal Medicine, University of Cologne, Germany. roman.pfister@uk-koeln.de
Diedrichs
Holger
H
Schiedermair
Anne
A
Rosenkranz
Stephan
S
Hellmich
Martin
M
Erdmann
Erland
E
Schneider
Christian Alfons
CA
D000368:Aged; D019540:Area Under Curve; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment; D012680:Sensitivity and Specificity
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine