Details

Autor(en) / Beteiligte

• Franke, Jennifer
• Frankenstein, Lutz
• Schellberg, Dieter
• Bajrovic, Amer
• Wolter, Jan Sebastian
• Ehlermann, Philipp
• Doesch, Andreas O.
• Nelles, Manfred
• Katus, Hugo A.
• Zugck, Christian

Titel

Is there an additional benefit of serial NT-proBNP measurements in patients with stable chronic heart failure receiving individually optimized therapy?

Ist Teil von

• Clinical research in cardiology, 2011-12, Vol.100 (12), p.1059-1067

Ort / Verlag

Berlin/Heidelberg: Springer-Verlag

Erscheinungsjahr

2011

Quelle

MEDLINE

Beschreibungen/Notizen

• Background The role of serial NT-proBNP measurements in patients suffering from chronic systolic heart failure (CHF) who already receive individually optimized pharmacotherapy is still unresolved. Methods NT-proBNP was assessed at baseline and at 6 months follow-up in 504 stable CHF patients treated with individually optimized pharmacotherapy. After assessment of clinical stability at 6 months, patients were followed up for at least 1 year. The combined primary endpoint was defined as death, hospitalization due to cardiac reasons or heart transplantation in 1-year follow-up. We stratified our patients according to two principles: first, a percent change of value (CV) between the first and second measurement of NT-proBNP and secondly, the transformed logarithm of NT-proBNP measured at 6 months. Results During the follow-up period of 1 year, 50 patients (9.9%) reached the combined primary endpoint. Stratification according to percentage CV was less accurate in predicting endpoint-free survival compared to a classification in categories of lnNT-proBNP measured at 6 months (ROC AUC = 0.615; 95% CI 0.525–0.70 vs. ROC AUC = 0.790; 95% CI 0.721–0.856, respectively). When entered into proportional hazard regression analysis, lnNT-proBNP measured at 6 months remained an independent predictor of the combined primary endpoint with an associated HR of 2.53 (95% CI 1.385–4.280). Conclusion To date, this is the largest analysis of serial NT-proBNP measurements in patients with CHF receiving individually optimized medical therapy. These data suggest that a single NT-proBNP measurement after 6 months in stable clinical conditions may have higher predictive value than stratification of change in serial measurements.