NT-proBNP independently predicted all-cause hospitalization in at-risk primary care patients (HR 1.001; 95% CI 1.000-1.001; p<0.001) and demonstrated excellent negative predictive value.
Observational (n=1,203)
Does NT-proBNP measurement predict hospitalisation in primary care patients at risk?
NT-proBNP is a strong independent predictor of hospitalisation in high-risk primary care patients, offering excellent negative predictive value to safely rule out the need for further diagnostic workup.
Effect estimate: HR 1.001 (95% CI 1.000-1.001)
p-value: p=< 0.001
BACKGROUND: In primary care, identification of patients who are at risk of major adverse events is of great importance. At the same time identifying individuals who are at very low risk and do not need further diagnostic workup and therapy is also important and may help to correctly allocate scarce healthcare resources. AIM: This study evaluated amino-terminal pro B-natriuretic peptide (NT-proBNP) as a risk marker in primary care patients with hypertension, diabetes, clinically suspected heart failure (HF), history of coronary artery disease or myocardial infarction. METHODS AND RESULTS: A prospective observational study was conducted in 1203 primary care patients. The primary endpoint, time to all-cause hospitalisation, was reached in 282 (24%) individuals within 12 months. Of all variables analysed, only NT-proBNP (HR 1.001 1.000-1.001, p < 0.001) and age (HR 1.018 1.007-1.028, p = 0.001) were of independent predictive value in a stepwise Cox regression analysis regarding all-cause hospitalisation. Neither systolic dysfunction nor signs and symptoms of HF added independent information to predict outcome. The negative predictive value (NPV) increased depending on the specificity of the endpoint (NPV was 86% for all-cause, 98% for cardiac and 100% for HF-related hospitalisation for 125 pg/ml). Positive predictive value and NPV were superior for NT-proBNP compared to clinical signs and symptoms of HF at every cut-point between 100 and 500 pg/ml. CONCLUSION: NT-proBNP levels predicted clinical events in primary care patients at risk. NPVs were excellent in this high risk population, proving NT-proBNP measurement a safe diagnostic tool.
Adlbrecht et al. (Fri,) conducted a observational in Hypertension, diabetes, clinically suspected heart failure, history of coronary artery disease or myocardial infarction (n=1,203). NT-proBNP measurement vs. Clinical signs and symptoms of heart failure was evaluated on Time to all-cause hospitalisation (HR 1.001, 95% CI 1.000-1.001, p=< 0.001). NT-proBNP independently predicted all-cause hospitalization in at-risk primary care patients (HR 1.001; 95% CI 1.000-1.001; p<0.001) and demonstrated excellent negative predictive value.
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