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NT‐proBNP in severe chronic heart failure: rationale, design and preliminary results of the COPERNICUS NT‐proBNP substudy
Author(s) -
Hartmann Franz,
Packer Milton,
Coats Andrew J.S.,
Fowler Michael B.,
Krum Henry,
Mohacsi Paul,
Rouleau Jean L.,
Tendera Michal,
Castaigne Alain,
Trawinski Jürgen,
AmannZalan Ildiko,
Hoersch Silke,
Katus Hugo A.
Publication year - 2004
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 - 10.1016/j.ejheart.2004.01.009
Subject(s) - medicine , heart failure , cardiology , copernicus , intensive care medicine , physics , astronomy
Background: Neither profiles nor prognostic value of cardiac N‐terminal proBNP (NT‐proBNP) have been prospectively evaluated in a sufficient number of patients with severe chronic heart failure (CHF) treated with carvedilol or placebo. Methods: Baseline and follow‐up plasma concentrations of NT‐proBNP were measured in the European part of the COPERNICUS Trial. This study enrolled patients with an ejection fraction <25% and symptoms of CHF at rest or on minimal exertion, equally randomized to placebo or carvedilol. Results: NT‐proBNP concentrations were increased at baseline (mean±S.D.=579±822 pmol/l, median=322.5 pmol/l) with a marked decrease during follow‐up in the carvedilol, but not in the placebo group. One‐year mortality rates were 3.9, 12 and 27.9% in the lower, middle and upper tertiles of NT‐proBNP, respectively. When mortality was calculated separately in the placebo and carvedilol group, rates were 0.8, 6.3 and 19.1% in the carvedilol treated but 6.7, 17.9 and 36.9% in the placebo treated patients. Conclusions: NT‐proBNP was a powerful predictor of subsequent all‐cause mortality in patients with severe CHF. This marker should therefore be further evaluated for risk stratification and monitoring of therapy in CHF.