Re-evaluation of prognostic significance of NT-proBNP in a 5-year follow-up study assessing all-cause mortality in elderly patients (?? 75 years) admitted to hospital due to suspect heart failure

摘要

Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a prognostic biomarker in heart failure (HF), especially in younger population. The prognostic value of NT-proBNP in an elderly HF population (?? 75 years) remains less studied. The purpose of this study is to evaluate the prognostic value of NT-proBNP in patients aged ?? 75 years and admitted to hospital due to suspect HF with a median follow-up of 5 years. Methods: A prospective hospital cohort of 243 patients (82 ?? 4 years) who had NT-proBNP analyzed due to suspect HF during 2005-2007 was studied. Results: Among the study population, 75% had acute decompensated HF. Multivariable Cox proportional-hazard regression analysis and univariable Kaplan-Meier survival analysis demonstrated that NT-proBNP was not prognostic significant in HF cohort ?? 75 years old, and instead, pulmonary hypertension, history of valvular surgery and use of aldosterone receptor antagonist were significant prognostic indicators. However, subgroup analysis showed that in patients with NT-proBNP levels > 8000 (ng/L), NT-proBNP is the only significant independent indicator for 5-year mortality whereas in patients with NT-proBNP ?? 8000 (ng/L), enlargement of left atrium and pulmonary hypertension, instead of NT-proBNP, were significant prognostic indicators for mortality. Conclusion: In a HF population ?? 75 years old with acute decompensated HF, NT-proBNP was not significant prognostic indicator, except in a subgroup with NT-proBNP > 8000 (ng/L). Therefore, the prognostic value of NT-proBNP in those HF patients ?? 75 years has to be interpreted with caution due to higher age and comorbidity. Crown