Document Detail


Prognostic values of NTpro BNP/BNP ratio in comparison with NTpro BNP or BNP alone in elderly patients with chronic heart failure in a 2-year follow up.
MedLine Citation:
PMID:  21334085     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Plasma BNP and NT-proBNP are often used as interchangeable parameters in heart failure care in clinical practice. In our previous study we have shown that inflammation was able to induce increased NT pro BNP in a hospital cohort with chronic heart failure in the elderly, indicating that NT-proBNP/BNP ratio should be evaluated concomitantly with inflammatory status to avoid overestimation of heart failure severity. The present study was aimed to evaluate the clinical significance of NT-proBNP/BNP ratio in comparison with NTpro BNP or BNP alone as a prognostic indicator in a 2-year follow up of elderly heart failure population. MATERIALS AND METHODS: One hundred and eight-nine elderly heart failure patients (72±11years, male 52%, LVEF 46±14%) were enrolled consecutively during 2006 and 2007 and followed up during 2years. NTpro BNP and BNP were measured routinely. RESULTS: We have found that NTpro BNP/BNP ratio provides no additional prognostic information during follow up as compared to NTpro BNP or BNP alone in an elderly population with chronic heart failure. By the use of ROC curves, for total mortality predictive accuracy during 2years, the cut-off values are NTproBNP≥800pg/ml, BNP>60pg/ml and NTpro BNP/BNP ratio>6.4 respectively. In terms of NTpro BNP, as long as its serum level is above 2000pg/ml it indicates poor prognosis. However there is an overlap between serum concentration range 2000-8000pg/ml and >8000pg/ml in terms of prognostic indicator. Similarly for BNP, as long as its serum level is above 100pg/ml, it indicates poor prognosis. However there is an overlap between serum concentration range 100-800pg/ml and >800pg/ml in terms of prognostic indicator. There was significant correlation between survival and NTpro BNP, BNP and Cystatin-C but not with NTpro BNP/BNP ratio. Such correlation exists irrespective of subgroups regardless of less than or older than 70years old. CONCLUSIONS: Our results demonstrated that in elderly heart failure population NTpro BNP/BNP ratio may provide diagnostic help in the presence of acute infection but no additional prognostic information in the long run as compared with NTpro BNP or BNP alone. Furthermore, both NTpro BNP and BNP are useful prognostic biomarkers indeed but they need to be interpreted with caution when it is used as a single biomarker and in the meantime concomitant diseases exist because patients may die due to non-cardiac causes.
Authors:
Juliana Jensen; Li-Ping Ma; Christian Bjurman; Ola Hammarsten; Michael L X Fu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-17
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Medicine, Sahlgrenska University Hospital, Sahlgrenska Academy at University of Gothenburg, 413 45 Gothenburg, Sweden.
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