title: New York Heart Association class versus amino-terminal pro-B type natriuretic peptide for acute heart failure prognosis.
abstract: BACKGROUND
  The prognostic value of the New York Heart Association classification (NYHAC) in acutely decompensated heart failure (ADHF) is unknown.
  
  
  OBJECTIVE
  We sought to determine the relative value of NYHAC among patients with concomitantly measured amino-terminal pro-B type natriuretic peptide (NT-proBNP) at presentation with ADHF.
  
  
  METHODS
  NYHAC was determined for 720 patients with ADHF and 1-year mortality status was examined. Cox-proportional hazards analysis compared the prognostic accuracy of NYHAC with other ADHF risk measures.
  
  
  RESULTS
  NYHAC had a significant univariate association with 1-year mortality status (HR 1.41, 95% confidence interval (CI) 1.03-1.94; p = 0.03) but was not a significant predictor of death in a multivariable model that included NT-proBNP (HR 2.14; 95% CI 1.65-2.81, p < 0.001).
  
  
  CONCLUSIONS
  In contrast to objective measures such as NT-proBNP, the NYHAC appears to provide limited prognostic information among individuals with ADHF.
authors.affiliation: Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. abaggish@partners.org
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Baggish
authors.forename: Roland R J
authors.initials: RR
authors.lastname: van Kimmenade
authors.forename: Yigal
authors.initials: Y
authors.lastname: Pinto
authors.forename: A Mark
authors.initials: AM
authors.lastname: Richards
authors.forename: John
authors.initials: J
authors.lastname: Lainchbury
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-Genis
authors.forename: Miquel
authors.initials: M
authors.lastname: Santaló
authors.forename: Jordi
authors.initials: J
authors.lastname: Ordonez-Llanos
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009518:New York; D018579:Patient Selection; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D016277:Ventricular Function, Left
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain