Prognostic impact of NT-proBNP and renal function in comparison to contemporary multi-marker risk scores in heart failure patients
Roman Pfister, Holger Diedrichs, Anne Schiedermair, Stephan Rosenkranz, Martin Hellmich, Erland Erdmann, Christian Alfons Schneider, Roman Pfister, Holger Diedrichs, Anne Schiedermair, Stephan Rosenkranz, Martin Hellmich, Erland Erdmann, Christian Alfons Schneider
Abstract
Background: Multi-marker risk scores accurately predict prognosis in heart failure patients but calculation is complex.
Aims: To compare the prognostic accuracy of the Seattle Heart Failure Survival Score (SHFS) and a model derived from the CHARM programme, with laboratory parameters NT-proBNP and glomerular filtration rate (GFR).
Methods and results: In a sample of 290 heart failure patients, 39 patients died, 22 were hospitalised with acute heart failure and 4 underwent urgent cardiac transplantation during a median follow-up of 498 days. NT-proBNP, GFR, CHARM and SHFS showed an AUC for an endpoint during 1-year of 0.80, 0.72, 0.79 and 0.69, respectively. The hazard ratio for an endpoint during follow-up was 2.1, 2.6, 1.9 and 2.1 per 1 SD increase of log NT-proBNP and CHARM and per 1 SD decrease of GFR and SHFS, respectively. In multivariate analysis, log NT-proBNP and GFR added independent prognostic information to CHARM and SHFS, respectively.
Conclusion: NT-proBNP and GFR independently predicted endpoint-free survival in systolic heart failure patients, with NT-proBNP being superior and equally predictive to the SHFS and CHARM score, respectively. Assessment of both laboratory markers can simplify prognostic stratification, addition to multi-marker scores should be evaluated.
Source: PubMed