Abstract | AIMS: In patients with heart failure (HF) and reduced ejection fraction, decreases or increases in NT-proBNP levels are associated with better and worse outcomes, respectively. The association in HF and preserved ejection fraction (HF-PEF) is unknown. We examined the association between change in level of NT-proBNP and prognosis in patients with HF-PEF. METHODS AND RESULTS: We examined the association between change in NT-proBNP from baseline to 6 months and cardiovascular (CV) death or HF hospitalization in 2612 participants in the Irbesartan in Patients with Heart Failure and Preserved Systolic Function Study (I-Preserve). Change in NT-proBNP was modelled as a restricted cubic spline in a Cox model after adjusting for baseline NT-proBNP and known prognostic variables. Median change in NT-proBNP from baseline was -7 pg/mL (interquartile range -143 to +108). After adjustment, a 1000 pg/mL decrease in NT-proBNP from baseline was associated with a reduction in the risk of CV death or HF hospitalization [hazard ratio (HR) 0.73, 95% confidence interval (CI) 0.53-1.02]; a 1000 pg/mL increase was associated with an increase in risk (HR 2.01, 95% CI 1.50-2.69). Beyond a 1000 pg/mL rise or fall, there was little additional change in risk. Addition of change in NT-proBNP at 6 months to a model with only baseline NT-proBNP improved the C-statistic from 0.752 to 0.769 (P = 0.013). CONCLUSION: In HF-PEF, a rise in NT-proBNP was associated with an increase in risk of CV death or HF hospitalization and a fall was associated with a trend towards a decrease in risk. NT-proBNP may be a useful marker to monitor prognosis in this condition.
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Authors | Pardeep S Jhund, Inder S Anand, Michel Komajda, Brian L Claggett, Robert S McKelvie, Michael R Zile, Peter E Carson, John J V McMurray |
Journal | European journal of heart failure
(Eur J Heart Fail)
Vol. 17
Issue 8
Pg. 809-17
(Aug 2015)
ISSN: 1879-0844 [Electronic] England |
PMID | 25921853
(Publication Type: Journal Article)
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Copyright | © 2015 The Authors. European Journal of Heart Failure © 2015 European Society of Cardiology. |
Chemical References |
- Biomarkers
- Peptide Fragments
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
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Topics |
- Aged
- Biomarkers
(blood)
- Female
- Heart Failure
(blood, mortality, physiopathology)
- Hospitalization
- Humans
- Male
- Natriuretic Peptide, Brain
(blood)
- Peptide Fragments
(blood)
- Prognosis
- Stroke Volume
- Treatment Outcome
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