Open AccessNT‐proBNP Provides Incremental Prognostic Information in Cardiac Outpatients With and Without Echocardiographic Findings
Author(s) -
Toggweiler Stefan,
Borst Oliver,
Enseleit Frank,
Hermann Matthias,
Ruschitzka Frank,
Lüscher Thomas F.,
Noll Georg
Publication year - 2011
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20894
Subject(s) - medicine , cardiology , natriuretic peptide , myocardial infarction , abnormality , heart failure , clinical significance , psychiatry
Background: Outpatients frequently present with elevated natriuretic peptides in the absence of an obvious cardiac abnormality or with normal natriuretic peptides despite echocardiographic findings. Hypothesis: 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. © 2011 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose. Stefan Toggweiler, MD and Oliver Borst, MD contributed equally to this work.