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Published on: October 1, 2019

A change in N-terminal pro-brain natriuretic peptide is predictive of outcome in patients with advanced heart failure

Roy S Gardner1, Kwok S Chong, James J Morton

  • 1Department of Cardiology, Glasgow Royal Infirmary, Glasgow, UK. rsgardner@doctors.org.uk <rsgardner@doctors.org.uk>

European Journal of Heart Failure
|October 7, 2006
PubMed

Insights

Monitoring NT-proBNP levels in advanced heart failure patients helps predict mortality risk. A high NT-proBNP concentration or an increase over time indicates a greater chance of death.

Area of Science:

  • Cardiology
  • Biomarkers
  • Prognostic Medicine

Background:

  • Modern therapy improves chronic heart failure (CHF) prognosis, but identifying high-risk patients remains challenging.
  • B-type natriuretic peptides are known predictors of CHF prognosis.
  • The prognostic value of changes in NT-proBNP over time in advanced CHF is not well understood.

Purpose of the Study:

  • To investigate the prognostic significance of NT-proBNP concentration and its change over time in advanced heart failure patients.
  • To determine if NT-proBNP levels can identify patients at high risk of mortality.

Main Methods:

  • Prospective study of 133 advanced CHF patients referred for cardiac transplantation evaluation.
  • Plasma NT-proBNP levels measured at baseline and 4 months in 112 surviving patients.
  • Median follow-up of 1003 days to assess all-cause mortality.

Main Results:

  • All-cause mortality occurred in 26.8% of patients.
  • Highest NT-proBNP at 4 months was significantly associated with increased mortality risk (p=0.001).
  • Both NT-proBNP above median and absolute increase in NT-proBNP independently predicted mortality (p<0.0001).

Conclusions:

  • A single NT-proBNP concentration above the median predicts mortality in advanced heart failure.
  • A change in NT-proBNP concentration over 4 months is an independent predictor of mortality.
  • NT-proBNP monitoring offers valuable prognostic information for advanced heart failure management.
Abstract

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