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Association between Survival Time and Changes in NT-proBNP in Cats Treated for Congestive Heart Failure
K V Pierce1, J E Rush1, L M Freeman1
1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.
Insights
Reductions in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in cats with congestive heart failure (CHF) indicate improved survival. A larger decrease in NT-proBNP during hospitalization correlated with longer survival times for feline CHF patients.
Area of Science:
- Veterinary Cardiology
- Biomarker Research
- Feline Health
Background:
- N-terminal pro-B-type natriuretic peptide (NT-proBNP) reductions are linked to better survival in human congestive heart failure (CHF) patients.
- Prognostic value of NT-proBNP changes in feline CHF is not well-established.
Purpose of the Study:
- To assess NT-proBNP concentration changes in cats with CHF post-treatment.
- To determine if serial NT-proBNP measurements offer prognostic insights for feline CHF.
Main Methods:
- Prospective observational study involving 31 cats with new-onset CHF.
- NT-proBNP levels measured at admission, discharge, and 7-10 day re-evaluation.
Main Results:
- Median NT-proBNP significantly decreased from admission to discharge and re-evaluation.
- A greater percentage decrease in NT-proBNP from admission to discharge was associated with longer survival.
- Active CHF at re-evaluation and owner difficulty administering medications predicted shorter survival.
Conclusions:
- Greater NT-proBNP reduction during hospitalization and absence of CHF at re-evaluation correlate with longer survival in cats.
- Further research is needed to explore NT-proBNP's role in guiding CHF treatment in cats.
Background:
Reductions in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations after treatment have been associated with improved survival in people with congestive heart failure (CHF), but have not been reported in cats with CHF.
Objectives:
To evaluate changes in NT-proBNP concentrations in cats with CHF after treatment and determine whether serial NT-proBNP measurements provide prognostic information.
Animals:
Thirty-one client-owned cats.
Methods:
Prospective, observational study in cats with new onset CHF secondary to cardiomyopathy. Concentrations of NT-proBNP were measured within 4 hours of admission to the hospital, on the day of discharge, and at re-evaluation 7-10 days later.
Results:
Median NT-proBNP concentrations decreased significantly from admission (1,713 pmol/L [range, 160-3,784 pmol/L]) to discharge (902 pmol/L [range, 147-3,223 pmol/L]); P = .005) and from admission to re-evaluation (1,124 pmol/L [range, 111-2,727 pmol/L]; P = .024). Median survival time was 109 days (range, 1-709 days), with 5 cats still alive at the time of analysis. Cats with a larger percent decrease in NT-proBNP from admission to discharge had a longer survival time (P = .048). Cats with evidence of active CHF at the time of re-evaluation (P = .010) and cats whose owners had difficulty administering medications (P = .045) had shorter survival times.
Conclusions And Clinical Importance:
Cats with a larger percent decrease in NT-proBNP during hospitalization and no evidence of CHF at the time of re-evaluation had longer survival times. Additional studies are needed to determine whether NT-proBNP can help guide treatment in cats with CHF.
