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Prognostic value of sequential measurements of amino‐terminal prohormone of B‐type natriuretic peptide in ambulatory heart failure patients
Author(s) -
Moertl Deddo,
Hammer Alexandra,
Huelsmann Martin,
Pacher Richard,
Berger Rudolf
Publication year - 2008
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.2008.02.018
Subject(s) - medicine , heart failure , natriuretic peptide , ambulatory , cardiology , clinical endpoint , prohormone , subgroup analysis , proportional hazards model , clinical trial , confidence interval , hormone
Background: We evaluated the prognostic value of sequential NT‐proBNP values in ambulatory heart failure patients after discharge, investigating whether the current value or the recent percent change is more important. Methods and results: In 166 patients, NT‐proBNP was measured at discharge from heart failure hospitalisation and three months later. The combined endpoint of death or heart failure rehospitalisation was evaluated after a maximum of 18 months or at follow‐up closure. During a mean observation time of 14±4 months, 63 patients (38%) reached the endpoint. In multiple Cox analysis, NT‐proBNP three months after discharge (NT‐proBNP‐3Mo) and NT‐proBNP percent change (NT‐proBNP‐%change) were the only independent predictors of the endpoint among various clinical and laboratory variables. After definition of a high‐ ( n = 83, 57% endpoints) and a low‐NT‐proBNP patient subgroup ( n = 83, 19% endpoints) according to the median NT‐proBNP‐3Mo (1751 pg/ml), NT‐proBNP‐%change was the strongest predictor in the high‐NT‐proBNP subgroup. In the low‐NT‐proBNP subgroup, NT‐proBNP‐3Mo was the only independent predictor. Conclusions: In ambulatory heart failure patients, the prognostic value of sequential NT‐proBNP measurements depends on the magnitude of the current NT‐proBNP value. Recent percent changes in NT‐proBNP provide important prognostic information in patients with high NT‐proBNP but not in patients with low NT‐proBNP.