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Visit-to-Visit B-Type Natriuretic Peptide Variability during the Previous Year Has Independent Prognostic Value in

Nobuyuki Kagiyama1,2, Takuya Yuri3, Akihiro Hayashida3

  • 1Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan, kgnb_27_hot@yahoo.co.jp.

Cardiology
|July 23, 2019
PubMed

Insights

Visit-to-visit B-type natriuretic peptide (BNP) variability in stable chronic heart failure (CHF) patients predicts adverse outcomes. High BNP variability, independent of BNP levels, indicates a higher risk of death or hospitalization.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Prognostic Medicine

Background:

  • Chronic heart failure (CHF) patients exhibit significant visit-to-visit (V2V) B-type natriuretic peptide (BNP) variability, even when clinically stable.
  • The prognostic implications of this V2V-BNP variability in stable CHF remain largely uninvestigated.

Purpose of the Study:

  • To evaluate the prognostic significance of V2V-BNP variability in stable CHF patients.
  • To determine if V2V-BNP variability predicts adverse outcomes independently of the absolute BNP level.

Main Methods:

  • Studied 278 stable CHF outpatients, measuring V2V-BNP variability as the coefficient of variance over one year.
  • Primary endpoint included all-cause death and heart failure rehospitalization over a median follow-up of 3.2 years.

Main Results:

  • Higher V2V-BNP variability (≥25.7%) was significantly associated with increased event rates (p=0.001).
  • This association remained independent of CHF severity, BNP levels, and MAGGIC risk scores in multivariable analyses.
  • Increased event risk was observed with rising V2V-BNP variability, particularly up to approximately 30%.

Conclusions:

  • V2V-BNP variability is a significant independent predictor of worse long-term outcomes in stable CHF.
  • BNP variability provides prognostic information beyond the baseline BNP level in chronic heart failure management.
Abstract

Keywords:
B-type natriuretic peptideBiomarkerHeart failureVisit-to-visit variability

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