The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease

Shihui Fu, Leiming Luo, Ping Ye, Shuangyan Yi, Yuan Liu, Bing Zhu, Liang Wang, Tiehui Xiao, Yongyi Bai Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China Objective: To analyze the relationship between N-terminal pro-brain natriuretic peptid...

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Autores principales: Fu S, Luo L, Ye P, Yi S, Liu Y, Zhu B, Wang L, Xiao T, Bai Y
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Publicado: Dove Medical Press 2013
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spelling oai:doaj.org-article:39ca114a51ee4c3ea1ce71187bbf62fc2021-12-02T04:34:37ZThe ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease1178-1998https://doaj.org/article/39ca114a51ee4c3ea1ce71187bbf62fc2013-04-01T00:00:00Zhttps://www.dovepress.com/the-ability-of-nt-probnp-to-detect-chronic-heart-failure-and-predict-a-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Shihui Fu, Leiming Luo, Ping Ye, Shuangyan Yi, Yuan Liu, Bing Zhu, Liang Wang, Tiehui Xiao, Yongyi Bai Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China Objective: To analyze the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and renal function, and compare the ability and cut-off thresholds of NT-proBNP to detect chronic heart failure (CHF) and predict mortality in elderly Chinese coronary artery disease (CAD) patients with and without chronic kidney disease (CKD). Methods: The study included 999 CAD patients older than 60 years. The endpoint was all-cause mortality over a mean follow-up period of 417 days. Results: The median age was 86 years (range: 60–104 years), and the median NT-proBNP level was 409.8 pg/mL. CKD was present in 358 patients. Three hundred and six patients were positive for CHF. One hundred and ten CKD patients and 105 non-CKD patients died. Not only CKD, but also estimated glomerular filtration rate independently affected NT-proBNP. NT-proBNP detected CHF with a cut-off value of 298.4 pg/mL in non-CKD patients and a cut-off value of 435.7 pg/mL in CKD patients. NT-proBNP predicted death with a cut-off value of 369.5 pg/mL in non-CKD patients and a cut-off value of 2584.1 pg/mL in CKD patients. The NT-proBNP level was significantly related to the prevalence of CHF and all-cause mortality in CAD patients with and without CKD; this effect persisted after adjustment. The crude and multiple adjusted hazard ratios of NT-proBNP to detect CHF and predict mortality were significantly higher in patients with CKD compared with the remainder of the population. The addition of NT-proBNP to the three-variable and six-variable models generated a significant increase in the C-statistic. Conclusion: Amongst elderly Chinese CAD patients, there was an independently inverse association between NT-proBNP and renal function. With the higher cutoff points, NT-proBNP better detected CHF and better predicted mortality in CKD patients than in non-CKD patients. Keywords: aged, coronary artery disease, chronic kidney disease, N-terminal pro-brain natriuretic peptide, prognosisFu SLuo LYe PYi SLiu YZhu BWang LXiao TBai YDove Medical PressarticleAgedCoronary Artery DiseaseChronic Kidney DiseaseN-terminal-pro-brain natriuretic peptidePrognosis.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 8, Pp 409-417 (2013)
institution DOAJ
collection DOAJ
language EN
topic Aged
Coronary Artery Disease
Chronic Kidney Disease
N-terminal-pro-brain natriuretic peptide
Prognosis.
Geriatrics
RC952-954.6
spellingShingle Aged
Coronary Artery Disease
Chronic Kidney Disease
N-terminal-pro-brain natriuretic peptide
Prognosis.
Geriatrics
RC952-954.6
Fu S
Luo L
Ye P
Yi S
Liu Y
Zhu B
Wang L
Xiao T
Bai Y
The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease
description Shihui Fu, Leiming Luo, Ping Ye, Shuangyan Yi, Yuan Liu, Bing Zhu, Liang Wang, Tiehui Xiao, Yongyi Bai Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China Objective: To analyze the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and renal function, and compare the ability and cut-off thresholds of NT-proBNP to detect chronic heart failure (CHF) and predict mortality in elderly Chinese coronary artery disease (CAD) patients with and without chronic kidney disease (CKD). Methods: The study included 999 CAD patients older than 60 years. The endpoint was all-cause mortality over a mean follow-up period of 417 days. Results: The median age was 86 years (range: 60–104 years), and the median NT-proBNP level was 409.8 pg/mL. CKD was present in 358 patients. Three hundred and six patients were positive for CHF. One hundred and ten CKD patients and 105 non-CKD patients died. Not only CKD, but also estimated glomerular filtration rate independently affected NT-proBNP. NT-proBNP detected CHF with a cut-off value of 298.4 pg/mL in non-CKD patients and a cut-off value of 435.7 pg/mL in CKD patients. NT-proBNP predicted death with a cut-off value of 369.5 pg/mL in non-CKD patients and a cut-off value of 2584.1 pg/mL in CKD patients. The NT-proBNP level was significantly related to the prevalence of CHF and all-cause mortality in CAD patients with and without CKD; this effect persisted after adjustment. The crude and multiple adjusted hazard ratios of NT-proBNP to detect CHF and predict mortality were significantly higher in patients with CKD compared with the remainder of the population. The addition of NT-proBNP to the three-variable and six-variable models generated a significant increase in the C-statistic. Conclusion: Amongst elderly Chinese CAD patients, there was an independently inverse association between NT-proBNP and renal function. With the higher cutoff points, NT-proBNP better detected CHF and better predicted mortality in CKD patients than in non-CKD patients. Keywords: aged, coronary artery disease, chronic kidney disease, N-terminal pro-brain natriuretic peptide, prognosis
format article
author Fu S
Luo L
Ye P
Yi S
Liu Y
Zhu B
Wang L
Xiao T
Bai Y
author_facet Fu S
Luo L
Ye P
Yi S
Liu Y
Zhu B
Wang L
Xiao T
Bai Y
author_sort Fu S
title The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease
title_short The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease
title_full The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease
title_fullStr The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease
title_full_unstemmed The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease
title_sort ability of nt-probnp to detect chronic heart failure and predict all-cause mortality is higher in elderly chinese coronary artery disease patients with chronic kidney disease
publisher Dove Medical Press
publishDate 2013
url https://doaj.org/article/39ca114a51ee4c3ea1ce71187bbf62fc
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