Abstract 13596: NT-ProBNP Guided Therapy Improves the Quality of Life in Patients with Chronic Heart Failure. Results From the ProBNP Outpatient Tailored Chronic Heart Failure Therapy Study.
Objectives: We recently showed that HF treatment guided by amino-terminal pro-B type natriuretic peptide (NT-proBNP) reduces cardiovascular event rates compared to standard-of-care (SOC) HF therapy, however the effect of NT-proBNP guided care on patient quality of life (QOL) remains unknown.
Methods: Subjects with HF due to left ventricular systolic dysfunction (LVSD) were randomized to either SOC HF management or HF care with a goal to reduce NT-proBNP values ≤1000 pg/mL. QOL was assessed using the Minnesota Living with HF Questionnaire (MLWHFQ) at baseline and follow-up visits.
Results: Over a treatment period of 10 months, 137 participants (mean age 63±14 yrs) had MLWHFQ data available from both baseline and final visits. MLWHFQ scores did not correlate with NT-proBNP at baseline (r=.06; P=.50), however, a direct correlation between follow-up MLWHFQ scores and NT-proBNP was seen (r=.23; P=.008); change in MLWHFQ scores also correlated to change in NT-proBNP values (r=.25; P=.003). Associations between post-treatment QOL and NT-proBNP are reflected in Figure 1. From baseline to follow-up, improved QOL was noted (median change -6 points; P =.12); larger changes were seen in the NT-proBNP arm versus SOC (-10 vs -5 points; P =.05). Large reduction in MLWHFQ scores (≥10 points) was more often seen in patients treated with NT-proBNP guided care (61 versus 39%; P =.03).
Conclusions: In patients with HF due to LVSD, compared to standard management, therapy guided by NT-proBNP leads to greater improvements in QOL.
- © 2011 by American Heart Association, Inc.