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The prognostic value of individual NT-proBNP values in chronic heart failure does not change with advancing age
  1. Lutz Frankenstein (lutz_frankenstein{at}med.uni-heidelberg.de)
  1. University of Heidelberg, Germany
    1. Andrew L Clark
    1. University of Hull, United Kingdom
      1. Kevin Goode
      1. University of Hull, United Kingdom
        1. Lee Ingle
        1. Leeds Metropolitan University, United Kingdom
          1. Andrew Remppis
          1. University of Heidelberg, Germany
            1. Dieter Schellberg
            1. University of Heidelberg, Germany
              1. Florian Grabs
              1. University of Heidelberg, Germany
                1. Manfred Nelles
                1. University of Heidelberg, Germany
                  1. John G F Cleland
                  1. University of Hull, United Kingdom
                    1. Hugo A Katus
                    1. University of Heidelberg, Germany
                      1. Christian Zugck
                      1. University of Heidelberg, Germany

                        Abstract

                        Objectives: It is unclear whether age-related increases in NT-proBNP represent a normal physiological process - possibly affecting the prognostic power of NT-proBNP - or reflect age-related sub-clinical pathological changes. Consequently, we aimed to determine the effect of age on the short-term prognostic value of NT-proBNP in patients with chronic heart failure (CHF).

                        Design: Prospective observational study with inclusion and matching of consecutive patients aged >65 years (73.1±6.0 years) to patients <65 years (53.7±8.6 years) with respect to NT-proBNP, NYHA, sex and aetiology of CHF (final n=443).

                        Setting: University Hospital Outpatient's in the UK and Germany.

                        Patients: Chronic stable heart failure due to systolic left ventricular dysfunction.

                        Intervention: None.

                        Outcome Measure: all-cause mortality.

                        Results: In both age-groups, NT-proBNP was a significant univariate predictor of mortality, and independent of age, sex and other established risk markers. The prognostic information given by NT-proBNP was comparable between the two groups, as reflected by the one year mortality of 9% in both groups. The prognostic accuracy of NT-proBNP as judged by the area under the receiver operating characteristics curve for the prediction of 1-year-mortality was comparable for elderly and younger patients (0.67 vs. 0.71; p=0.09).

                        Conclusion: NT-proBNP reflects disease severity in elderly and younger patients alike. In patients with chronic stable heart failure, the NT-proBNP value carries the same one year prognostic information regardless of the age of the patient.

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