NT-proBNP prognostic value is maintained in elderly and very elderly patients with chronic systolic heart failure
| Autor: | Chiara Arzilli, Michele Emdin, Alessandro Valleggi, James L. Januzzi, Luc Zyw, Roberta Poletti, Concetta Prontera, Claudio Passino, Alessandra Gabutti, Alberto Aimo, Alain Cohen Solal, Giuseppe Vergaro, Andrea Barison, Alberto Giannoni, Chiara Mammini |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Prohormone Heart failure 030204 cardiovascular system & hematology 03 medical and health sciences Age 0302 clinical medicine Internal medicine Natriuretic Peptide Brain Medicine Humans Natriuretic peptides cardiovascular diseases 030212 general & internal medicine Prospective Studies Mortality education NT-proBNP Cardiology and Cardiovascular Medicine Aged Heart transplantation Aged 80 and over education.field_of_study Ejection fraction business.industry Middle Aged medicine.disease Brain natriuretic peptide Prognosis Peptide Fragments Quartile Cohort Chronic Disease Cardiology Female business hormones hormone substitutes and hormone antagonists Biomarkers medicine.drug Follow-Up Studies Heart Failure Systolic |
| Zdroj: | International journal of cardiology. 271 |
| ISSN: | 1874-1754 |
| Popis: | Circulating concentrations of N-terminal fragment of the prohormone of brain natriuretic peptide (NT-proBNP) are influenced by age and common age-related comorbidities, such as renal dysfunction. Therefore, utility of NT-proBNP for prediction of prognosis in the aged has been questioned. We aimed to investigate the prognostic value of NT-proBNP across age classes in a cohort of patients with chronic systolic HF.We enrolled 2364 consecutive outpatients with HF and left ventricular ejection fraction ≤50%. Patients were classified according to age quartiles, and a very elderly subgroup was identified, aged ≥85 years. After baseline assessment (including NT-proBNP testing), patients were followed-up for the composite of cardiovascular death, heart transplantation or ventricular assistance device implantation (primary outcome) and for all-cause death (secondary outcome). Patients in the fourth quartile (Q4, age ≥ 77 years, n = 638) and in the very elderly subgroup (age ≥ 85 years, n = 153), had higher NT-proBNP (p .001 vs Q1). NT-proBNP was independently associated with primary and secondary outcome at 1- and 5-years follow-up in the whole population, as well as in Q4 and in the very elderly subgroup (all p .05). Compared to the whole population, Q4 and very elderly had higher NT-proBNP cut-off for prediction of 1-year primary (4188 and 9729 ng/l, respectively vs 3710 ng/l) and secondary outcome (4296 and 7634 ng/l, respectively vs 3056 ng/l).NT-proBNP predicts mortality in elderly and very elderly patients with chronic systolic HF, both at mid- and long-term follow-up. Higher NT-proBNP prognostic cut-off should be considered in the aged HF population. |
| Databáze: | OpenAIRE |
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