Prognostic threshold levels of NT-proBNP testing in primary care

J. Rosenberg; M. Schou; F. Gustafsson; J. Badskjaer; P. Hildebrandt

doi:10.1093/eurheartj/ehn525

Prognostic threshold levels of NT-proBNP testing in primary care

J. Rosenberg, M. Schou, F. Gustafsson, J. Badskjaer, P. Hildebrandt

Department of Clinical Medicine

25 Citations (Scopus)

Abstract

AIMS: Chronic heart failure (HF) is a common condition with a poor prognosis. As delayed diagnosis and treatment of HF patients in primary care can be detrimental, risk-stratified waiting lists for echocardiography might optimize resource utilization. We investigated whether a prognostic threshold level of the cardiac peptide, NT-proBNP, could be identified. METHODS AND RESULTS: From 2003-2005, 5875 primary care patients with suspected HF (median age 73 years) had NT-proBNP analysed in the Copenhagen area. Eighteen percent died and 20% had a cardiovascular (CV) hospitalization (median follow-up time: 1127 and 1038 days, respectively). In Cox proportional hazards regression models regarding NT-proBNP levels, the fourth decile (range: 83-118 pg/mL) was associated with a 90% (95% CI: 30-190, P < 0.01) increased risk for CV hospitalization and the seventh decile (range: 229-363 pg/mL) was associated with an 80% (95% CI: 20-190, P = 0.01) increased mortality risk after adjustment for age, sex, previous hospitalization, CV diseases, and chronic diseases. CONCLUSION: We identified prognostic threshold levels for mortality and CV hospitalization for NT-proBNP in primary care patients suspected of HF. Our results have the potential to be used to risk-stratify waiting lists for echocardiography
Udgivelsesdato: 2009/1

Original language	English
Journal	European Heart Journal
Volume	30
Issue number	1
Pages (from-to)	66-73
Number of pages	7
ISSN	0195-668X
DOIs	https://doi.org/10.1093/eurheartj/ehn525
Publication status	Published - 2008

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10.1093/eurheartj/ehn525

Cite this

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title = "Prognostic threshold levels of NT-proBNP testing in primary care",

abstract = "AIMS: Chronic heart failure (HF) is a common condition with a poor prognosis. As delayed diagnosis and treatment of HF patients in primary care can be detrimental, risk-stratified waiting lists for echocardiography might optimize resource utilization. We investigated whether a prognostic threshold level of the cardiac peptide, NT-proBNP, could be identified. METHODS AND RESULTS: From 2003-2005, 5875 primary care patients with suspected HF (median age 73 years) had NT-proBNP analysed in the Copenhagen area. Eighteen percent died and 20% had a cardiovascular (CV) hospitalization (median follow-up time: 1127 and 1038 days, respectively). In Cox proportional hazards regression models regarding NT-proBNP levels, the fourth decile (range: 83-118 pg/mL) was associated with a 90% (95% CI: 30-190, P < 0.01) increased risk for CV hospitalization and the seventh decile (range: 229-363 pg/mL) was associated with an 80% (95% CI: 20-190, P = 0.01) increased mortality risk after adjustment for age, sex, previous hospitalization, CV diseases, and chronic diseases. CONCLUSION: We identified prognostic threshold levels for mortality and CV hospitalization for NT-proBNP in primary care patients suspected of HF. Our results have the potential to be used to risk-stratify waiting lists for echocardiography Udgivelsesdato: 2009/1",

author = "J. Rosenberg and M. Schou and F. Gustafsson and J. Badskjaer and P. Hildebrandt",

note = "Keywords: Aged; Aged, 80 and over; Biological Markers; Female; Heart Failure; Hospitalization; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Primary Health Care; Prognosis; Proportional Hazards Models; Prospective Studies; Risk; Survival Rate",

year = "2008",

doi = "10.1093/eurheartj/ehn525",

language = "English",

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T1 - Prognostic threshold levels of NT-proBNP testing in primary care

AU - Rosenberg, J.

AU - Schou, M.

AU - Gustafsson, F.

AU - Badskjaer, J.

AU - Hildebrandt, P.

N1 - Keywords: Aged; Aged, 80 and over; Biological Markers; Female; Heart Failure; Hospitalization; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Primary Health Care; Prognosis; Proportional Hazards Models; Prospective Studies; Risk; Survival Rate

PY - 2008

Y1 - 2008

N2 - AIMS: Chronic heart failure (HF) is a common condition with a poor prognosis. As delayed diagnosis and treatment of HF patients in primary care can be detrimental, risk-stratified waiting lists for echocardiography might optimize resource utilization. We investigated whether a prognostic threshold level of the cardiac peptide, NT-proBNP, could be identified. METHODS AND RESULTS: From 2003-2005, 5875 primary care patients with suspected HF (median age 73 years) had NT-proBNP analysed in the Copenhagen area. Eighteen percent died and 20% had a cardiovascular (CV) hospitalization (median follow-up time: 1127 and 1038 days, respectively). In Cox proportional hazards regression models regarding NT-proBNP levels, the fourth decile (range: 83-118 pg/mL) was associated with a 90% (95% CI: 30-190, P < 0.01) increased risk for CV hospitalization and the seventh decile (range: 229-363 pg/mL) was associated with an 80% (95% CI: 20-190, P = 0.01) increased mortality risk after adjustment for age, sex, previous hospitalization, CV diseases, and chronic diseases. CONCLUSION: We identified prognostic threshold levels for mortality and CV hospitalization for NT-proBNP in primary care patients suspected of HF. Our results have the potential to be used to risk-stratify waiting lists for echocardiography Udgivelsesdato: 2009/1

AB - AIMS: Chronic heart failure (HF) is a common condition with a poor prognosis. As delayed diagnosis and treatment of HF patients in primary care can be detrimental, risk-stratified waiting lists for echocardiography might optimize resource utilization. We investigated whether a prognostic threshold level of the cardiac peptide, NT-proBNP, could be identified. METHODS AND RESULTS: From 2003-2005, 5875 primary care patients with suspected HF (median age 73 years) had NT-proBNP analysed in the Copenhagen area. Eighteen percent died and 20% had a cardiovascular (CV) hospitalization (median follow-up time: 1127 and 1038 days, respectively). In Cox proportional hazards regression models regarding NT-proBNP levels, the fourth decile (range: 83-118 pg/mL) was associated with a 90% (95% CI: 30-190, P < 0.01) increased risk for CV hospitalization and the seventh decile (range: 229-363 pg/mL) was associated with an 80% (95% CI: 20-190, P = 0.01) increased mortality risk after adjustment for age, sex, previous hospitalization, CV diseases, and chronic diseases. CONCLUSION: We identified prognostic threshold levels for mortality and CV hospitalization for NT-proBNP in primary care patients suspected of HF. Our results have the potential to be used to risk-stratify waiting lists for echocardiography Udgivelsesdato: 2009/1

U2 - 10.1093/eurheartj/ehn525

DO - 10.1093/eurheartj/ehn525

M3 - Journal article

C2 - 19029123

SN - 0195-668X

VL - 30

SP - 66

EP - 73

JO - European Heart Journal

JF - European Heart Journal

IS - 1

ER -