Abstract 14173: Comparable Prognostic Impacts of B-type Natriuretic Peptide Levels bBetween Heart Failure With Reduced and Preserved Ejection Fraction -a Report From the CHART-2 Study
Introduction: Although the usefulness of B-type natriuretic peptide (BNP) has been established as an excellent prognostic predictor for heart failure (HF) with reduced left ventricular ejection fraction (LVEF) (HFrEF), it remains to be examined whether this is also the case for HF with preserved LVEF (HFpEF).
Methods: We examined the usefulness of plasma levels of BNP for long-term risk stratification in 4,301 consecutive chronic HF patients in Stage C/D (mean age 69 ± 12 years, female 32%) in our Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-2 Study (N=10,219). We compared the prognostic impacts of BNP levels between patients with HFrEF (LVEF<50%, N=1,408) and those with HFpEF (LVEF≥50%, N=2,893) by performing survival analyses including Kaplan Meier curves, log-rank tests and Cox proportional hazard models.
Results: During the median 6.3-year follow-up period, 1,435 all-cause deaths, 660 cardiovascular (CV) deaths, 600 non-CV deaths and 1,161 HF admissions occurred. Although HFpEF patients had significantly lower BNP levels than HFrEF patients (median 85.3 vs. 164.8 pg/ml, P <0.001), the mortality risk was comparable between the 2 groups when analyzed with the cutoff BNP levels obtained by the classification and regression trees (CART) analysis. As compared with the patients with BNP <30 pg/ml (reference), those with higher BNP levels (30-99, 100-299 and ≥300 pg/ml) had significantly increased mortality risk in a concentration-dependent manner (all P <0.01) (Figure). Importantly, the prognostic impacts of BNP levels for all-cause death, CV death, non-CV death and HF admission were comparable between the two groups in each BNP category (all P for interaction >0.1 (n.s.)).
Conclusions: These results indicate that although HFpEF patients have lower BNP levels than HFrEF patients, measured BNP values have comparable prognostic impacts between HFpEF and HFrEF.
Author Disclosures: S. Kasahara: None. Y. Sakata: None. T. Yamauchi: None. T. Onose: None. K. Tsuji: None. R. Abe: None. T. Oikawa: None. M. Sato: None. K. Nochioka: None. T. Shiroto: None. J. Takahashi: None. S. Miyata: None. H. Shimokawa: Speakers Bureau; Modest; Daiichi-Sankyo, Bayer Yakuhin.
- © 2016 by American Heart Association, Inc.