Simultaneous Assessment of Unprocessed ProBNP 1-108 in Addition to Processed BNP32 Improves Identification of High-Risk Ambulatory Patients With Heart Failure
Key result
Higher proBNP 1-108 linked to ~390% greater risk of death or cardiac transplantation.
- HR 4.9
- 95% CI 2.5 to 9.7
- P<0.001
- n=756
Why the study?
Simultaneous assessment of unprocessed proBNP(1-108) and processed BNP32 may improve risk stratification in patients with chronic systolic heart failure.
Does the addition of proBNP(1-108) to BNP32 improve risk stratification for all-cause death or cardiac transplantation in ambulatory patients with chronic systolic heart failure?
Population
756 outpatients with predominantly systolic heart failure in the Penn Heart Failure Study
Comparison
Higher versus lower proBNP(1-108) levels in addition to BNP32 measurement
Design
Prospective cohort study
Authors
Discussion
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Member takes
Implication
May aid risk stratification beyond BNP32 in ambulatory systolic HF; leaves open prospective validation before practice change.
Study Design
Type
Cohort (n=756)
Structured PICO
Does the addition of proBNP(1-108) to BNP32 improve risk stratification for all-cause death or cardiac transplantation in ambulatory patients with chronic systolic heart failure?
P
Population
756 outpatients with predominantly systolic heart failure.
E
Exposure
Measurement of plasma proBNP(1-108) levels in addition to BNP32
C
Comparator
Lower levels of proBNP(1-108) (first tertile) or BNP32 measurement alone
O
Outcome
All-cause death or cardiac transplantationhard clinical
Main Result
Hazard Ratio: 4.9 (95% CI 2.5–9.7)
p-value: p=<0.001
Simultaneous measurement of unprocessed proBNP(1-108) and processed BNP32 improves risk stratification in ambulatory systolic heart failure patients, particularly when BNP32 levels are low.
Cite This Study
Dries et al. (2010) conducted a cohort in chronic systolic heart failure (n=756). Higher levels of proBNP(1-108) vs. First proBNP(1-108) tertile was evaluated on all-cause death or cardiac transplantation (HR 4.9, 95% CI 2.5 to 9.7, p=<0.001). Higher levels of proBNP(1-108) were associated with an increased risk of all-cause death or cardiac transplantation (adjusted HR 4.9; 95% CI 2.5-9.7; P<0.001 for third vs first tertile).