The prognostic value of individual NT-proBNP values in chronic heart failure does not change with advancing age.
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.
Frankenstein
L
L
Department of Cardiology, Angiology, Pulmonology, University of Heidelberg, Heidelberg, Germany. Lutz.Frankenstein@med.uni-heidelberg.de
Clark
A L
AL
Goode
K
K
Ingle
L
L
Remppis
A
A
Schellberg
D
D
Grabs
F
F
Nelles
M
M
Cleland
J G F
JG
Katus
H A
HA
Zugck
C
C
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*
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain