Abstract 3388: Baseline Plasma NT-proBNP Concentrations in Relation to Clinical Characteristics: Results from the Irbesartan in Heart Failure with Preserved Systolic Function Trial
Objective: Plasma N terminal B type natriuretic factor (NT-proBNP) concentration is usually elevated in patients with heart failure (HF) and reduced systolic function and is a useful “rule out test” for that diagnosis. Conversely, little is known about NT-proBNP in patients with HF and preserved systolic function (HFPSF). Consequently, we measured NT-proBNP in 3485 patients with HFPSF, randomized in the Irbesartan in Heart Failure with Preserved Systolic Function trial (I-PRESERVE).
Methods: Patients with symptoms/signs of HF, ejection fraction (EF) ≥45%, age ≥60 years, and either NYHA II-IV symptoms with HF hospitalization within 6 months (HF Hosp) or NYHA III-IV symptoms with corroborative ECG, radiologic (pulm congestion) or echocardiographic evidence of cardiac disease were recruited into the study. The NT-proBNP was measured in a central laboratory using the Elecsys proBNP assay (Roche) and reported as the mean±SE pg/ml.
Results: Mean age 72±7 years, 60% women, 97% NYHA class II or III, concomitant medication: diuretics 83%, ACE inhibitor 25%, β-blocker 59% and spironolactone 15%. The mean NT-proBNP was 349.0±8.1 pg/ml. NT-proBNP increased with advancing age and was greater in men compared to women (mean 387.1±14.5 pg/ml vs 325.8±9.6 pg/ml, p=0.0003) Table⇓: NT-proBNP Related to Clinical Findings 1 ≥median Creatinine; 2 anemia (<11.5 gm/dl); 3 < median EF (59%); 4 heart rate ≥ 80 bpm; 5 CXR pulmonary congestion
Conclusions: Clinical findings associated with more severe HFPSF, such as HF hosp, pulmonary congestion, increased creatinine, anemia, lower EF or AF on ECG, had higher NT-proBNP levels. Therefore, NT-proBNP is elevated in HFPSF patients and further increased in those with co-morbid conditions, thus potentially representing a marker of increased risk.