Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort

Journal article


Campbell, Duncan J., Gong, Fei Fei, Jelinek, Michael V., Castro, Julian M., Coller, Jennifer M., McGrady, Michele, Boffa, Umberto, Shiel, Louise, Wang, Bing H., Liew, Danny, Wolfe, Rory, Stewart, Simon, Owen, Alice J., Krum, Henry, Reid, Christopher M. and Prior, David L.. (2019). Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort. European Journal of Heart Failure. 21, pp. 449-459. https://doi.org/10.1002/ejhf.1381
AuthorsCampbell, Duncan J., Gong, Fei Fei, Jelinek, Michael V., Castro, Julian M., Coller, Jennifer M., McGrady, Michele, Boffa, Umberto, Shiel, Louise, Wang, Bing H., Liew, Danny, Wolfe, Rory, Stewart, Simon, Owen, Alice J., Krum, Henry, Reid, Christopher M. and Prior, David L.
Abstract

Aims
We investigated which serum amino-terminal pro-B-type-natriuretic peptide (NT-proBNP) levels inform heart failure (HF) risk in a community-based population at increased cardiovascular disease (CVD) risk.

Methods and results
Inclusion criteria were age ≥ 60 years with one or more of self-reported hypertension, diabetes, heart disease, abnormal heart rhythm, cerebrovascular disease, or renal impairment. Exclusion criteria were known HF, ejection fraction (EF) < 50%, or more than mild valve abnormality. NT-proBNP levels were measured in 3842 participants on enrolment. HF was diagnosed in 162 participants at a median of 4.5 (interquartile range 2.7–5.4) years after enrolment, 73 with HF with preserved EF (HFpEF), 53 with HF with reduced EF (HFrEF), and 36 with valvular HF (VHF). Areas under the receiver operating characteristic curve (AUC) for 5-year prediction of total HF were similar for NT-proBNP alone (0.79, 95% confidence interval 0.74–0.83) and a 7-parameter multivariable model (0.82, 0.77–0.86, P = 0.035). NT-proBNP cut-points of 11, 16, and 25 pmol/L for individuals aged 60–69, 70–79, and ≥ 80 years, respectively, achieved sensitivities > 76% and specificities of 47–69% for 5-year prediction of total HF in men and women in all three age groups. Sensitivities were ≥ 75% in most subgroups according to body mass index, estimated glomerular filtration rate, and the presence or absence of atrial fibrillation, pacemaker, or CVD, and for the prediction of HFpEF, HFrEF and VHF.

Conclusion
Age-specific serum NT-proBNP levels inform prognosis, and hence therapeutic decisions, regarding HF risk in individuals at increased CVD risk.

KeywordsNT-proBNP; natriuretic peptides; incident heart failure; prevention; epidemiology •risk factors
Year2019
JournalEuropean Journal of Heart Failure
Journal citation21, pp. 449-459
PublisherThe European Society of Cardiology
ISSN1388-9842
Digital Object Identifier (DOI)https://doi.org/10.1002/ejhf.1381
Scopus EID2-s2.0-85060202426
Research or scholarlyResearch
Page range449-459
FunderNational Health and Medical Research Council (NHMRC)
Publisher's version
Output statusPublished
Publication dates
Print18 Jan 2019
Publication process dates
Accepted11 Nov 2018
Deposited03 Jun 2021
Grant IDNHMRC/0559010
NHMRC/1044619
NHMRC/1092642
NHMRC/0395508
NHMRC/1045862
NHMRC/1136372
NHMRC/1041796
NHMRC/0620241
NHMRC/0519456
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