Journal of Cardiac Failure
Volume 13, Issue 4 , Pages 275-280, May 2007

Amino Terminal B-Type Natriuretic Peptide, Renal Function, and Prognosis in Acute Heart Failure: A Hospital Cohort Study

  • Joana Martins Pimenta, MD

      Affiliations

    • From the Departments of Internal Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    • Corresponding Author InformationReprint requests: Joana Martins Pimenta, MD, Hospital de S. João, Faculdade de Medicina da Universidade do Porto, Porto 4200–319, Portugal.
    • ,
  • Rui Almeida, MD

      Affiliations

    • Cardiology, Hospital de S. João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    • ,
  • José Paulo Araújo, MD

      Affiliations

    • From the Departments of Internal Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    • ,
  • Ana Azevedo, MD

      Affiliations

    • From the Departments of Internal Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    • ,
  • Fernando Friões, MD

      Affiliations

    • From the Departments of Internal Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    • ,
  • Francisco Rocha-Gonçalves, MD, PhD

      Affiliations

    • Cardiology, Hospital de S. João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    • ,
  • António Ferreira, MD, PhD

      Affiliations

    • From the Departments of Internal Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    • ,
  • Paulo Bettencourt, MD, PhD

      Affiliations

    • From the Departments of Internal Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

Received 27 June 2006; received in revised form 28 December 2006; accepted 4 January 2007.

Porto, Portugal

Abstract 

Background

Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is a valuable diagnostic and prognostic test in heart failure (HF). Limited information is available concerning its use in patients with renal failure, in whom dependence on renal clearance may negatively affect its performance.

Methods and Results

We evaluated influence of renal function on NT-proBNP levels and on its prognostic value after hospital discharge in 283 acute HF patients. Admission and discharge NT-proBNP levels were higher in patients with decreased estimated glomerular filtration rate (eGFR). In these patients discharge NT-proBNP above median was associated to occurrence of death or readmission at 6 months (hazard ratio [HR] 2.53, 95% confidence interval [CI] 1.27–5.03); in patients with normal eGFR, a trend to this association was found (HR 1.64, CI 0.98–2.76). Decrease in NT-proBNP less than 30% of baseline was associated to outcome in patients with normal eGFR (HR 2.68, CI 1.54–4.68) and decreased eGFR (HR 2.54, CI 1.49–4.33).

Conclusions

Acute HF patients with renal failure have higher NT-proBNP levels than those with normal renal function. Discharge NT-proBNP has long-term prognostic value in HF patients with renal dysfunction. NT-proBNP variations during hospitalization provide additional prognostic information either in patients with normal or reduced eGFR.

Key Words: NT-proBNP, heart decompensation, renal failure, event-free survival

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PII: S1071-9164(07)00002-4

doi:10.1016/j.cardfail.2007.01.001

Journal of Cardiac Failure
Volume 13, Issue 4 , Pages 275-280, May 2007

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