Clinical and echocardiographic characteristics of individuals aged 75/76 years old with screening-detected elevated NT-proBNP levels.

Autor:	Al-Khalili F; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.; Heart, Lung and Allergy Clinic, Sophiahemmet Hospital, Stockholm, Sweden., Kemp-Gudmundsdottir K; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden., Svennberg E; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden., Fredriksson T; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden., Frykman V; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden., Friberg L; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden., Rosenqvist M; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden., Engdahl J; Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2020 Feb 19; Vol. 7 (1), pp. e001200. Date of Electronic Publication: 2020 Feb 19 (Print Publication: 2020).
DOI:	10.1136/openhrt-2019-001200
Abstrakt:	Background: High plasma levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) indicate increased probability of congestive heart failure (CHF) and atrial fibrillation (AF) and are associated with poor prognosis. Objective: We aimed to describe the clinical and echocardiographic characteristics of a population of individuals aged 75/76 years old with NT-proBNP ≥900 ng/L without previously known CHF or AF. Methods: All individuals aged 75/76 years in the Stockholm region were randomised to a screening study for AF. Half of them were invited to screening. Of those invited, 49.5% agreed to participate. Individuals with NT-proBNP ≥900 ng/L without known CHF were invited for further clinical evaluation. Results: Among 6315 participants without AF who had NT-proBNP sampled, 102 without previously known CHF had ≥900 ng/L. Of these, 93 completed further clinical investigations. In the population that was clinically investigated, 53% were female, and the median NT-proBNP was 1200 ng/L. New AF was found in 28 (30%). The NT-proBNP value in this group was not significantly different from those where AF was not detected (median 1285 vs 1178 ng/L). Patients with newly detected AF had larger left atrial volume and higher pulmonary artery pressure than those without AF. Preserved left ventricular ejection fraction (≥50%) was found in 86% of the participants, mid-range ejection fraction (40%-49%) in 3.2% and reduced ejection fraction (<40%) in 10.8%. Thirteen patients (14%) had other serious cardiac disorders that required medical attention. Conclusion: Elderly individuals with NT-proBNP levels ≥900 ng/L constitute a population at high cardiovascular risk even in the absence of diagnosed CHF or AF, and therefore merit further investigation. Competing Interests: Competing interests: FA-K has received lecture fees from Bayer, Boehringer Ingelheim and BMS/Pfizer. KK-G has received a research grant from Stiftelsen Hjärtat and received lecture fees from BMS/Pfizer. ES has received lecture fees from Bayer, Bristol-Myers Squibb-Pfizer, Boehringer Ingelheim and Sanofi. LF has received consultancy fees from Bayer, Boehringer Ingelheim, BMS/Pfizer and Sanofi. TF has received unrestricted research grants from Boehringer Ingelheim and Stiftelsen Hjärtat. VF has received lecture fees from Merck Sharp & Dohme, Boehringer Ingelheim, Bayer and Medtronic. JE has received consultancy fees from Bristol-Myers Squibb and Pfizer, lecture fees from Merck Sharp & Dohme and Medtronic, and unrestricted research grants from Pfizer. MR received consultancy and lecture fees from Medtronic, Zenicor, Bayer, Boehringer Ingelheim, Pfizer, Bristol-Myers Squibb and Abbott, and research grants from Roche Diagnostics, Bristol-Myers Squibb, Sanofi, Boehringer Ingelheim and Bayer. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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