title: NT-proBNP provides incremental prognostic information in cardiac outpatients with and without echocardiographic findings.
abstract: BACKGROUND
  Outpatients frequently present with elevated natriuretic peptides in the absence of an obvious cardiac abnormality or with normal natriuretic peptides despite echocardiographic findings.
  
  
  OBJECTIVE
  We aimed to determine the prognostic value of N-terminal pro B-type natriuretic peptide (NTpBNP) in outpatients with normal and abnormal echocardiography.
  
  
  METHODS
  A total of 433 cardiovascular outpatients were included. The prognostic value of NTpBNP in patients with normal and abnormal echocardiography during a 2-year follow-up was evaluated.
  
  
  RESULTS
  Patients with abnormal echocardiography and elevated NTpBNP had a mortality rate of 8.7% and an overall event rate of 20.2% (composite end point of overall mortality, myocardial infarction, and hospitalization for heart failure), which was significantly higher than in patients with abnormal echocardiography and normal NTpBNP, in which no mortality (P=0.011) and no events were observed (P<0.001). In patients with a normal echocardiography, mortality was 1.5% and 1.8% for patients with normal and elevated NTpBNP, respectively (P=1.000). Composite event rate was 1.5% and 8.9% (P=0.093), respectively.
  
  
  CONCLUSIONS
  Patients with low NTpBNP have an excellent prognosis irrespective of echocardiographic findings. Therefore, determination of NTpBNP appears useful in assessing the clinical relevance of echocardiographic findings.
authors.affiliation: Department of Cardiology, Cardiovascular Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Toggweiler
authors.forename: Oliver
authors.initials: O
authors.lastname: Borst
authors.forename: Frank
authors.initials: F
authors.lastname: Enseleit
authors.forename: Matthias
authors.initials: M
authors.lastname: Hermann
authors.forename: Frank
authors.initials: F
authors.lastname: Ruschitzka
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Georg
authors.initials: G
authors.lastname: Noll
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality; D015150:Echocardiography, Doppler; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain; D010045:Outpatients; D010446:Peptide Fragments; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D045283:Natriuretic Agents; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain