Results from a 6-year follow-up of a Swedish population in primary care regarding b-type natriuretic peptide (bnp) and the aminoterminal fragment of proBNP (n-terminal proBNP) and risk for cardiovascular death in elderly patients with possible heart failure.
(English)Manuscript (preprint) (Other academic)
Heart failure is common in the elderly population and carries a serious prognosis. Identification of risk factors for cardiovascular mortality among primary care patients is important.
To evaluate EDTA-plasma brain natriuretic peptide (BNP) and the aminoterminal fragment of proBNP (N-terminal proBNP) as prognostic markers in elderly with symptoms of mild to moderate heart failure.
From 474 patients attending primary care for symptoms of dyspnoea, fatigue and/or peripheral oedema blood was sampled in plastic tubes containing EDTA in order to measure BNP by non-extraction immunoradiometric assay and of N-terminal proBNP by non-extraction radioimmunoassay. Patients were evaluated with respect to history and clinical- and laboratory examinations with particular reference to cardiac structure and function. Follow-up time was 6 years. A Cox regression analysis was performed to identify the weight of risk variables.
During the follow-up period of 6 years the total mortality was 16 % (75 patients out of 474), and cardiovascular mortality was 11% (52 patients). Cardiovascular mortality increased with increased plasma concentration of BNP or N-terminal proBNP. Both pep tides were useful prognostic markers for cardiovascular mortality in patients with heart failure. In those with the highest quartile of plasma concentration of BNP and N=terminal proBNP, 9.9 times and 5.0 times increased risk for CV death were identified respectively.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-84703OAI: oai:DiVA.org:liu-84703DiVA: diva2:561228