[Long-term prognosis of serum and urine n-terminal proBNP levels and glomerular filtration rate in heart failure patients].
OBJECTIVE
The amino-terminal pro-brain natriuretic peptide (NT-proBNP) and estimated glomerular filtration rate (eGFR) values are related to short prognosis in patients with heart failure (HF). This study evaluates the prognostic power of serum and urinary NT-proBNP levels, and eGFR values, in HF patients during a 60-month follow-up.


METHODS
We studied 93 HF outpatients (66 males, age 65+/-12). Primary endpoint was defined as cardiovascular mortality and secondary endpoint as cardiovascular mortality or admissions.


RESULTS
Only serum NT-proBNP levels had a significant area under the curve for the prognosis of 60-month mortality and combined events, 0.70 (p=0.004) and 0.67 (p=0.019), respectively. Urinary NT-proBNP and eGFR did not have statistical significant areas under the curve. Patients with high serum NT-proBNP had the highest risk of cardiovascular death [44 (IC 95% 38-50) vs. 56 (IC 95% 53-59) months, p=0.0006] and combined events [33 (IC 95% 28-38) vs. 42 (IC 95% 28-38) months; p=0.027]. After the integration of serum NT-proBNP and renal function, patients with high peptide levels and low eGFR had the worst survival [42 (IC 95% 33-52) months; p=0.010]. Finally, only serum NT-proBNP concentration above 933 pg/mL was a predictor of poor survival (hazard ratio=2.81, p=0.033) and NT-proBNP above 550 pg/mL for combined events (hazard ratio=1.79, p=0.049).


CONCLUSIONS
Serum NT-proBNP levels were superior to urine NT-proBNP and eGFR values for predicting 60-month cardiovascular death and combined events in HF patients.
Cortés
Raquel
R
Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, España.
Rivera
Miguel
M
Martínez-Dolz
Luís
L
Jordán
Alejandro
A
Roselló-Lletí
Esther
E
Miró
Vicente
V
Portolés
Manuel
M
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000378:metabolism* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000652:urine*; D010446:Peptide Fragments / Q000097:blood* / Q000652:urine*; D011379:Prognosis; D013997:Time Factors
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain