RT Journal Article
SR Electronic
T1 Prognostic value of NT-proBNP in heart failure with preserved versus reduced EF
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1881
OP 1888
DO 10.1136/heartjnl-2015-307782
VO 101
IS 23
A1 Si-Hyuck Kang
A1 Jin Joo Park
A1 Dong-Ju Choi
A1 Chang-Hwan Yoon
A1 Il-Young Oh
A1 Seok-Min Kang
A1 Byung-Su Yoo
A1 Eun-Seok Jeon
A1 Jae-Joong Kim
A1 Myeong-Chan Cho
A1 Shung Chull Chae
A1 Kyu-Hyung Ryu
A1 Byung-Hee Oh
YR 2015
UL http://heart.bmj.com/content/101/23/1881.abstract
AB Objective Plasma level of N-terminal–pro-brain natriuretic peptide (NT-proBNP) is a reliable prognostic factor in patients with heart failure (HF). However, it is unclear how differently the biomarker predicts adverse outcomes in HF with preserved EF (HFpEF) versus HF with reduced EF (HFrEF).Methods From the Korean Heart Failure registry, a prospective multicentre cohort for consecutive patients who were hospitalised for acute HF syndrome, those with available NT-proBNP and LVEF measurements were extracted. Patients with LVEF ≥50% were categorised as the HFpEF group (N=528) and those with ≤40% as the HFrEF group (N=1142).Results Patients with HFpEF had significantly lower NT-proBNP level than those with HFrEF (median 2723 vs 5644 ng/L, p<0.001). Event-free survival did not differ between the two groups either in terms of death from any cause (88.4% vs 86.9%; p=0.471) or the composite of death or HF readmission at 1 year (73.8% vs 70.6%; p=0.225). High levels of NT-proBNP were significantly associated with poor outcomes. However, the relationship was not different among the HFpEF and HFrEF groups (interaction p=0.956 for all-cause death; p=0.351 for the composite of all-cause death or HF hospitalisation).Conclusions Plasma level of NT-proBNP is the most powerful prognostic factor in both HFpEF and HFrEF. Although patients with HFpEF have lower NT-proBNP levels, the prognosis of a patient with HFpEF expected from a given NT-proBNP level is similar with his/her counterpart with HFrEF.