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

Duncan J. Campbell, Fei Fei Gong, Michael V. Jelinek, Julian M. Castro, Jennifer M. Coller, Michele McGrady, Umberto Boffa, Louise Shiel, Bing H. Wang, Danny Liew, Rory Wolfe, Simon Stewart, Alice J. Owen, Henry Krum, Christopher M. Reid, David L. Prior

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)449-459
Number of pages11
JournalEuropean Journal of Heart Failure
Volume21
Issue number4
DOIs
Publication statusPublished - Apr 2019

Keywords

  • Epidemiology
  • Incident heart failure
  • Natriuretic peptides
  • NT-proBNP
  • Prevention
  • Risk factors

Cite this

Campbell, D. J., Gong, F. F., Jelinek, M. V., Castro, J. M., Coller, J. M., McGrady, M., ... Prior, D. 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(4), 449-459. https://doi.org/10.1002/ejhf.1381
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. ; Prior, David L. / Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort. In: European Journal of Heart Failure. 2019 ; Vol. 21, No. 4. pp. 449-459.
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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.",
keywords = "Epidemiology, Incident heart failure, Natriuretic peptides, NT-proBNP, Prevention, Risk factors",
author = "Campbell, {Duncan J.} and Gong, {Fei Fei} and Jelinek, {Michael V.} and Castro, {Julian M.} and Coller, {Jennifer M.} and Michele McGrady and Umberto Boffa and Louise Shiel and Wang, {Bing H.} and Danny Liew and Rory Wolfe and Simon Stewart and Owen, {Alice J.} and Henry Krum and Reid, {Christopher M.} and Prior, {David L.}",
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Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort. / 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.; Prior, David L.

In: European Journal of Heart Failure, Vol. 21, No. 4, 04.2019, p. 449-459.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort

AU - Campbell, Duncan J.

AU - Gong, Fei Fei

AU - Jelinek, Michael V.

AU - Castro, Julian M.

AU - Coller, Jennifer M.

AU - McGrady, Michele

AU - Boffa, Umberto

AU - Shiel, Louise

AU - Wang, Bing H.

AU - Liew, Danny

AU - Wolfe, Rory

AU - Stewart, Simon

AU - Owen, Alice J.

AU - Krum, Henry

AU - Reid, Christopher M.

AU - Prior, David L.

PY - 2019/4

Y1 - 2019/4

N2 - 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.

AB - 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.

KW - Epidemiology

KW - Incident heart failure

KW - Natriuretic peptides

KW - NT-proBNP

KW - Prevention

KW - Risk factors

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U2 - 10.1002/ejhf.1381

DO - 10.1002/ejhf.1381

M3 - Article

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SP - 449

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JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

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ER -