Key result
Elevated NT-proBNP and NYHA class strongly predict mortality better than LVEF in elderly patients.
Why the study?
Do NT-proBNP levels and NYHA class predict mortality better than LVEF or chest radiography in elderly heart failure patients?
Cohort (n=365)
No
Do NT-proBNP levels and NYHA class predict mortality better than LVEF or chest radiography in elderly heart failure patients?
In elderly heart failure patients, NT-proBNP combined with NYHA class provides superior prognostic information for mortality compared to LVEF or chest radiography.
May aid mortality risk stratification in elderly HF; leaves open prospective validation versus LVEF-based approaches.
All patients older than 65 years (184 men; mean age, 78+/-0.8 years/181 women; mean age, 82+/-0.6 years) seeking medical attention at the Lund University Hospital Emergency Clinic during a 2-year period who had an N-terminal prohormone brain natriuretic peptide (NT-proBNP) value >2000 pg/mL were followed up for survival. Mortality in the entire population was 21% after 3 months, 35% after 1 year, and 40% after 2 years. Multivariate analysis indicated that the NT-proBNP level and the New York Heart Association (NYHA) functional class were stronger predictors of mortality than were echocardiographic estimation of left ventricular ejection fraction or chest radiography. Patients who survived the first year were younger, had higher systolic blood pressure, had lower plasma creatinine, had lower inflammatory activity, and were treated with lower doses of furosemide. The results indicate that in this population, NT-proBNP level together with assessment of NYHA class gives the best prognostic information of 1-year mortality.
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Andersson et al. (2008) conducted a cohort in Heart Failure (n=365). NT-proBNP level and NYHA functional class vs. Echocardiographic LVEF or chest radiography was evaluated on Mortality. In elderly patients with NT-proBNP >2000 pg/mL, mortality was 40% at 2 years, and NT-proBNP level with NYHA class were stronger predictors of mortality than LVEF or chest radiography.
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