title: The prognostic value of individual NT-proBNP values in chronic heart failure does not change with advancing age.
abstract: BACKGROUND
  It is unclear whether age-related increases in N-terminal pro-brain natriuretic peptide (NT-proBNP) represent a normal physiological process-possibly affecting the prognostic power-of NT-proBNP-or reflect age-related subclinical pathological changes.
  
  
  OBJECTIVE
  To determine the effect of age on the short-term prognostic value of NT-proBNP in patients with chronic heart failure (CHF).
  
  
  METHODS
  Prospective observational study with inclusion and matching of consecutive patients aged >65 years (mean (SD) 73.1 (6.0) years) to patients <65 years (53.7 (8.6) years) with respect to NT-proBNP, New York Heart Association stage, sex and aetiology of CHF (final n = 443).
  
  
  METHODS
  University hospital outpatient departments in the UK and Germany.
  
  
  METHODS
  Chronic stable heart failure due to systolic left ventricular dysfunction.
  
  
  METHODS
  None.
  
  
  METHODS
  All-cause mortality.
  
  
  RESULTS
  In both age groups, NT-proBNP was a significant univariate predictor of mortality, and independent of age, sex and other established risk markers. The prognostic information given by NT-proBNP was comparable between the two groups, as reflected by the 1-year mortality of 9% in both groups. The prognostic accuracy of NT-proBNP as judged by the area under the receiver operating characteristics curve for the prediction of 1-year mortality was comparable for elderly and younger patients (0.67 vs 0.71; p = 0.09).
  
  
  CONCLUSIONS
  NT-proBNP reflects disease severity in elderly and younger patients alike. In patients with chronic stable heart failure, the NT-proBNP value carries the same 1-year prognostic information regardless of the age of the patient.
authors.affiliation: Department of Cardiology, Angiology, Pulmonology, University of Heidelberg, Heidelberg, Germany. Lutz.Frankenstein@med.uni-heidelberg.de
authors.forename: L
authors.initials: L
authors.lastname: Frankenstein
authors.forename: A L
authors.initials: AL
authors.lastname: Clark
authors.forename: K
authors.initials: K
authors.lastname: Goode
authors.forename: L
authors.initials: L
authors.lastname: Ingle
authors.forename: A
authors.initials: A
authors.lastname: Remppis
authors.forename: D
authors.initials: D
authors.lastname: Schellberg
authors.forename: F
authors.initials: F
authors.lastname: Grabs
authors.forename: M
authors.initials: M
authors.lastname: Nelles
authors.forename: J G F
authors.initials: JG
authors.lastname: Cleland
authors.forename: H A
authors.initials: HA
authors.lastname: Katus
authors.forename: C
authors.initials: C
authors.lastname: Zugck
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D004812:Epidemiologic Methods; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000097:blood / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D018579:Patient Selection; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D006113:United Kingdom; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000401:mortality*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain