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Prediction of incident heart failure by serum amino‐terminal pro‐B‐type natriuretic peptide level in a community‐based cohort
Author(s) -
Campbell Duncan J.,
Gong Fei Fei,
Jelinek Michael V.,
Castro Julian M.,
Coller Jennifer M.,
McGrady Michele,
Boffa Umberto,
Shiel Louise,
Wang Bing H.,
Liew Danny,
Wolfe Rory,
Stewart Simon,
Owen Alice J.,
Krum Henry,
Reid Christopher M.,
Prior David L.
Publication year - 2019
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.1381
Subject(s) - medicine , heart failure , natriuretic peptide , cardiology , interquartile range , atrial fibrillation , ejection fraction , population , renal function , receiver operating characteristic , cohort , confidence interval , environmental health
Aims We investigated which serum amino‐terminal pro‐B‐type‐natriuretic peptide (NT‐proBNP) levels inform heart failure (HF) risk in a community‐based population at increased cardiovascular disease (CVD) risk. Methods and results Inclusion criteria were age ≥ 60 years with one or more of self‐reported hypertension, diabetes, heart disease, abnormal heart rhythm, cerebrovascular disease, or renal impairment. Exclusion criteria were known HF, ejection fraction (EF) < 50%, or more than mild valve abnormality. NT‐proBNP levels were measured in 3842 participants on enrolment. HF was diagnosed in 162 participants at a median of 4.5 (interquartile range 2.7–5.4) years after enrolment, 73 with HF with preserved EF (HFpEF), 53 with HF with reduced EF (HFrEF), and 36 with valvular HF (VHF). Areas under the receiver operating characteristic curve (AUC) for 5‐year prediction of total HF were similar for NT‐proBNP alone (0.79, 95% confidence interval 0.74–0.83) and a 7‐parameter multivariable model (0.82, 0.77–0.86, P = 0.035). NT‐proBNP cut‐points of 11, 16, and 25 pmol/L for individuals aged 60–69, 70–79, and ≥ 80 years, respectively, achieved sensitivities > 76% and specificities of 47–69% for 5‐year prediction of total HF in men and women in all three age groups. Sensitivities were ≥ 75% in most subgroups according to body mass index, estimated glomerular filtration rate, and the presence or absence of atrial fibrillation, pacemaker, or CVD, and for the prediction of HFpEF, HFrEF and VHF. Conclusion Age‐specific serum NT‐proBNP levels inform prognosis, and hence therapeutic decisions, regarding HF risk in individuals at increased CVD risk.