Key result
NT-pro-BNP levels >12,200 pg/ml were associated with a higher risk of all-cause mortality in patients with end-stage renal disease and cardiovascular disease (HR 3.05; 95% CI 1.96-4.77; p<0.0001).
Why the study?
Does elevated NT-pro-BNP predict all-cause mortality in patients with ESRD and documented CVD?
Cohort (n=206)
Does elevated NT-pro-BNP predict all-cause mortality in patients with ESRD and documented CVD?
NT-pro-BNP is an independent predictor of mortality in patients with ESRD and documented CVD, with levels >12,200 pg/ml indicating a 3-fold higher risk of death.
Answers are grounded in this paper and cite their sources.
NT-pro-BNP >12,200 pg/ml may refine mortality risk stratification in ESRD with CVD; leaves open whether biomarker-guided interventions improve outcomes.
AIM: Patients with end-stage renal disease (ESRD) have an increased mortality from cardiovascular disease (CVD). N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is an independent predictor of mortality in patients with ischemic heart disease and congestive heart failure. Previous data have shown markedly elevated levels of NT-pro-BNP in patients with ESRD, while the prognostic value of elevated levels of NT-pro-BNP in patients with ESRD is largely unknown. The aim of the present study was to examine if the level of NT-pro-BNP predicts mortality in patients with ERSD and CVD. METHODS: We prospectively followed 206 patients with ESRD and documented CVD. Levels of NT-pro-BNP were measured at baseline, and patients were followed for 2 years or until they reached the predefined endpoint of all-cause mortality. RESULTS: During follow-up, the total mortality was 44% (90/206). Patients who died were followed for a median of 314 days (interquartile range 179 - 530). Using Cox regression analysis, age, female sex, systolic blood pressure, dialysis efficiency and plasma levels of NT-pro-BNP were independent prognostic risk factors of mortality. In receiver operating characteristic curve analysis a cut off value for NT-pro-BNP was determined. Patients with values of NT-pro-BNP above 12.200 pg/ml had a 3 times higher risk of death than patients below the cut-off value (HR 3.05 95% CI 1.96 - 4.77, p < 0.0001). CONCLUSION: In spite of generally elevated levels of NT-pro-BNP, NT-pro-BNP is still an independent predictor of mortality and might add prognostic information in patients with ESRD and documented CVD.
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Svensson et al. (2009) conducted a cohort in End-stage renal disease and cardiovascular disease (n=206). NT-pro-BNP > 12,200 pg/ml vs. NT-pro-BNP ≤ 12,200 pg/ml was evaluated on all-cause mortality (HR 3.05, 95% CI 1.96 - 4.77, p=< 0.0001). NT-pro-BNP levels >12,200 pg/ml were associated with a higher risk of all-cause mortality in patients with end-stage renal disease and cardiovascular disease (HR 3.05; 95% CI 1.96-4.77; p<0.0001).
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