New York Heart Association class versus amino-terminal pro-B type natriuretic peptide for acute heart failure prognosis.
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.
Baggish
Aaron L
AL
Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. abaggish@partners.org
van Kimmenade
Roland R J
RR
Pinto
Yigal
Y
Richards
A Mark
AM
Lainchbury
John
J
Bayes-Genis
Antoni
A
Santaló
Miquel
M
Ordonez-Llanos
Jordi
J
Januzzi
James L
JL
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
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain