Abstract 14751: Rising NT-probnp Levels Are Associated With Reduced Survival in Patients With Patients With Heart Failure With Preserved Ejection Fraction (HFpEF) and Reduced Ejection Fraction (HFrEF)
Objective/Aim: To determine the impact of temporal trends in NT-proBNP levels on 6-month survival in HFpEF and HFrEF.
Introduction: High levels NT-proBNP are associated with reduced survival patients with heart failure. However, it remains to be conclusively demonstrated that in addition to absolute NT-proBNP levels, temporal trends in NT-proBNP level in individual patients also impact survival.
Methods: We conducted a retrospective study on a cohort of 8255 patients who had at least one admission to the hospital with diagnoses of heart failure between Jan 2011 and Dec 2014.Using EMR data, we created a dataset that included all NT-proBNP levels obtained on these patients at any time during the study interval, irrespective of whether the test was done in a hospital or clinic setting. We used text-mining techniques to extract the numerical value of ejection fraction from reports of echocardiograms obtained during this interval. We performed multivariate regression analysis to identify factors independently associated with six-month survival. In addition, we also constructed Kaplan-Meier curves to determine the impact of temporal trends in NT-proBNP in individual patients on 6-month survival.
Results: For patients with HFpEF (EF>45%), and HFrEF, maximum NT-proBNP levels achieved during the study period were associated with higher odds of 6-month mortality (p <0.05). Independent of the absolute NT-proBNP level, patients with a rising BNP level had higher odds of 6-month mortality (Odds ratio (OR): 1.29-1.52) as compared to patients with stable or declining NT-proBNP levels. This was true both for patients with HFpEF (OR: 1.30-1.66) and for patients with HFrEF (OR: 1.13-1.43). Kaplan-Meier survival curves demonstrated significantly higher 6 month survival rates for patients that did not have a net rise in NT-proBNP levels for patients both the subtypes of HF. (p <0.05)
Conclusion: A rising NT-proBNP level is associated with higher 6-month mortality in patients with HFpEF as well as HFrEF. This may indicate that the use of NT-proBNP guided therapy for patients with heart failure merits further study.
Author Disclosures: T. Poonacha: None. N. Sahni: None.
- © 2015 by American Heart Association, Inc.