NT-proBNP was a strong independent predictor of mortality (HR 5.70, p<0.0001) and hospital admissions for heart failure (HR 13.83, p<0.0001) in the general population.
Cohort (n=672)
Yes
Does plasma NT-proBNP concentration accurately diagnose systolic heart failure and predict mortality and hospital admissions in the general population?
NT-proBNP is a highly sensitive diagnostic screening tool for systolic heart failure and a strong independent predictor of mortality and cardiac admissions in the general population.
Effect estimate: HR 5.70
p-value: p=< 0.0001
OBJECTIVE: To evaluate N-terminal pro-brain natriuretic peptide (NT-proBNP) as a diagnostic and prognostic marker for systolic heart failure in the general population. DESIGN: Study participants, randomly selected to be representative of the background population, filled in a heart failure questionnaire and underwent pulse and blood pressure measurements, electrocardiography, echocardiography, and blood sampling and were followed up for a median (range) period of 805 (60-1171) days. SETTING: Participants were recruited from four randomly selected general practitioners and were examined in a Copenhagen university hospital. PATIENTS: 382 women and 290 men in four age groups (50-59 (n = 174); 60-69 (n = 204); 70-79 (n = 174); > or = 80 years (n = 120)). MAIN OUTCOME MEASURES: Value of NT-proBNP in evaluating patients with symptoms of heart failure and impaired left ventricular (LV) systolic function; prognostic value of NT-proBNP for mortality and hospital admissions. RESULTS: In 38 (5.6%) participants LV ejection fraction (LVEF) was < or = 40%. NT-proBNP identified patients with symptoms of heart failure and LVEF < or = 40% with a sensitivity of 0.92, a specificity of 0.86, positive and negative predictive values of 0.11 and 1.00, and area under the curve of 0.94. NT-proBNP was the strongest independent predictor of mortality (hazard ratio (HR) = 5.70, p < 0.0001), hospital admissions for heart failure (HR = 13.83, p < 0.0001), and other cardiac admissions (HR = 3.69, p < 0.0001). Mortality (26 v 6, p = 0.0003), heart failure admissions (18 v 2, p = 0.0002), and admissions for other cardiac causes (44 v 13, p < 0.0001) were significantly higher in patients with NT-proBNP above the study median (32.5 pmol/l). CONCLUSIONS: Measurement of NT-proBNP may be useful as a screening tool for systolic heart failure in the general population.
Groenning et al. (Fri,) conducted a cohort in Systolic heart failure (n=672). NT-proBNP measurement was evaluated on Mortality (HR 5.70, p=< 0.0001). NT-proBNP was a strong independent predictor of mortality (HR 5.70, p<0.0001) and hospital admissions for heart failure (HR 13.83, p<0.0001) in the general population.