Comparison of the Diagnostic Accuracy of Plasma N-Terminal Pro-Brain Natriuretic Peptide in Patients <80 to those >80 Years of Age with Heart Failure

• Published in: The American journal of cardiology 2018-12, Vol.122 (12), p.2075-2079
• Main Authors: Draper, Jane, Webb, Jessica, Jackson, Tom, Jones, Hamish, Rinaldi, Christopher A, Schiff, Rebekah, McDonagh, Theresa, Razavi, Reza, S Carr-White, Gerald
• Format: Article
• Language: English
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2018.09.004

Plasma N-Terminal Pro-Brain Natriuretic Peptide (NTproBNP) is known to increase with age, however, the performance of this biomaker is unclear in patients >80. This study sought to define the diagnostic accuracy of plasma NTproBNP in patients >80 in a large unselected population of heart failure (HF) patients admitted to a Tertiary Hospital in the United Kingdom. 1,995 consecutive patients over a 12 month period were screened for HF through our NTproBNP led HF service. 413 patients had their first presentation of HF and 36.1% of these patients were >80. There was a reduction in accuracy of NTproBNP with age according to the area under the curve, with an area under the curve for all HF patients of 0.734 and a 7.5% reduction in receiver operating characteristic curve area for patients >80 years compared with those under 60 to 79 years of age. The lowest NTproBNP recorded for patients with HF >80 years of age was 466 pg/ml. In HF patients >80, 40.6% patients were diagnosed with HFrEF, 31.1% with HFpEF and 28.2% with HFmrEF. Overall NTproBNP is less accurate at identifying HF in patients >80 years of age and the lowest NTproBNP recorded for a HF patient was 466 pg/ml suggesting that the NTproBNP threshold for ruling out HF in patients >80 years of age should be modified.