Serum NT-proBNP levels are a prognostic predictor in patients with advanced heart failure

To verify if the determination of NT-proBNP values would help predict the prognosis in advanced heart failure (HF) patients. One hundred and five subjects with average age of 52.4 years were evaluated, 66.6% of them males. Thirty-three (32.0%) subjects were outpatients and 70 (67.9%) were inpatients...

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Bibliographic Details
Published in:Arquivos brasileiros de cardiologia 2006-08, Vol.87 (2), p.174-177
Main Authors: Pereira-Barretto, Antonio Carlos, de Oliveira, Jr, Mucio Tavares, Strunz, Célia Cassaro, Del Carlo, Carlos Henrique, Scipioni, Airton Roberto, Ramires, José Antonio Franchini
Format: Article
Language:Portuguese
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Brazil - epidemiology
Epidemiologic Methods
Female
Heart Failure - blood
Heart Failure - mortality
Humans
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Prognosis
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Summary:To verify if the determination of NT-proBNP values would help predict the prognosis in advanced heart failure (HF) patients. One hundred and five subjects with average age of 52.4 years were evaluated, 66.6% of them males. Thirty-three (32.0%) subjects were outpatients and 70 (67.9%) were inpatients (functional class III/IV) admitted to the hospital for cardiac compensation. All patients had left ventricular systolic dysfunction and a mean ejection fraction of 0.29. The NT-proBNP levels were measured in all patients and they were followed-up over a period from 2 to 90 days (average 77 days). A ROC curve was drawn to determine the best cut-off point, as well as the corresponding Kaplan-Meyer survival curves. During the follow-up period, 22 patients died. The average NT-proBNP value of the patients who remained alive was 6,443.67+/-6,071.62 pg/ml, whereas that of those who died was 14,609.66+/-12,165.15 pg/ml (p=0.001). The ROC curve identified a cut-off point at 6,000 pg/ml with 77.3% sensitivity (area under the curve: 0.74). The survival curve for values below and above 6,000 pg/ml was significantly different (p=0.002): patients with values below 6,000 pg/ml had a 90.2% 90-day survival, and those patients with values above, a 66% survival. Patients with advanced HF, especially those admitted to the hospital for cardiac compensation, had much higher NT-proBNP values, with a two-fold increase among those who died during the follow-up period. Values above 6,000 pg/ml identify the patients most likely to die within 90 days after hospital discharge.
ISSN:0066-782X