NT-proBNP for risk prediction of cardiovascular events and all-cause mortality: The getABI-study
| Autor: | Winfried März, Hans J. Trampisch, Henrik Rudolf, Kaffer Kara, Hubert Scharnagl, Andreas Mügge |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Cardiovascular mortality 030204 cardiovascular system & hematology Asymptomatic 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine 030212 general & internal medicine Natriuretic peptides Prospective cohort study Original Paper business.industry Proportional hazards model Incidence (epidemiology) Prevention Hazard ratio Biomarker medicine.disease Primary care Confidence interval lcsh:RC666-701 Heart failure Biomarker (medicine) medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. Heart & Vasculature International Journal of Cardiology: Heart & Vasculature, Vol 29, Iss, Pp 100553-(2020) |
| ISSN: | 2352-9067 |
| Popis: | Background Beside their role in the diagnosis of heart failure in symptomatic patients with dyspnea, natriuretic peptides have been suggested to improve risk prediction of cardiac events and mortality in asymptomatic cohorts. We aimed to evaluate the prognostic value of NT-proBNP for cardiovascular and all-cause mortality above traditional risk factors in a prospective cohort study of unselected elderly patients in a representative primary care setting. Methods We followed 6382 patients of the getABI-study for 7 years. Associations of NT-proBNP levels (≤125; 125–300; >300pg/ml for all) with all-cause and cardiovascular mortality were assessed using cox regression analysis. Results The incidence of all-cause and cardiovascular mortality was higher in subjects with higher levels of NT-proBNP (all-cause mortality/cardiovascular mortality: 35.4%/6% for NT-proBNP > 300 pg/ml; 16.2%/40% for NT-proBNP 125–300 pg/ml vs. 11.4%/4% for NT-proBNP ≤ 125 pg/ml. Participants with a NT-proBNP levels > 300pg/ml had increased incidence of hard endpoint (hazard ratio (HR) (95% confidence interval (CI)): 3.62 (3.15–4.17) for all-cause mortality, and 6.38 (4.84–8.41) for cardiovascular mortality). These associations remained after adjustment for traditional risk factors and cardiac medications and diseases (HR = 2.64 (2.26–3.08) for all-cause mortality, and HR = 3.93 (2.90–5.32) for cardiovascular mortality). Conclusion Our results show strong associations of higher NT-proBNP levels with cardiovascular and all-cause mortality in an unselected, large population of elderly patients in the primary care setting independent of traditional risk factors indicating that NT-proBNP can help identifying subjects at high risk for cardiac events. |
| Databáze: | OpenAIRE |
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