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 language | English |
|---|---|
| Pages (from-to) | 449-459 |
| Number of pages | 11 |
| Journal | European Journal of Heart Failure |
| Volume | 21 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2019 |
Keywords
- Epidemiology
- Incident heart failure
- Natriuretic peptides
- NT-proBNP
- Prevention
- Risk factors
Cite this
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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 journal › Article › Research › peer-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
UR - http://www.scopus.com/inward/record.url?scp=85060202426&partnerID=8YFLogxK
U2 - 10.1002/ejhf.1381
DO - 10.1002/ejhf.1381
M3 - Article
VL - 21
SP - 449
EP - 459
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 4
ER -