Abstract 17029: Plasma B-type Natriuretic Peptide Levels and the Risk of Death in Clinically-referred Patients With and Without Heart Failure
Introduction: B-type natriuretic peptide (BNP) levels are an important predictor of mortality in heart failure (HF) patients. Less is known about the prognostic significance of BNP in clinically-referred patients without HF.
Hypothesis: The risk of death associated with elevated plasma BNP levels is similar between patients with and without HF.
Methods: Using the Vanderbilt University Medical Center electronic health record, we studied 30,487 patients (mean age 62 years, 50% men, 17% black, 38% HF) who had a first BNP measurement between 2002 and 2013. Multivariable-adjusted Cox proportional-hazards models were used to quantify the risk of death from any cause according to plasma BNP level. Death was ascertained via linkage to the Social-Security Death Index with follow-up through 2015.
Results: Compared with HF patients, non-HF patients were younger and less likely to have coronary artery disease, chronic kidney disease, diabetes, and hypertension. BNP levels were significantly lower in non-HF (median 89 pg/ml; IQR 34-238) compared with HF patients (388; 150-940), P<0.0001. During a median follow-up of 2.7 years, 6,181 (53%) HF and 5,903 (31%) non-HF patients died. In multivariable models that included demographic and clinical characteristics, BNP was the strongest predictor of death in both HF and non-HF patients. An increase in BNP from the 25th to 75th percentile was associated with a 96% (95%CI 89-103%) increase in the risk of death (P<0.0001). The risk of death associated with high plasma BNP levels was nearly the same in patients with and without HF (Figure).
Conclusions: In a clinically-referred population, an elevated BNP has the same prognostic significance in patients without HF as it does in patients with HF.
Author Disclosures: M.K. York: None. C.F. Reynolds: None. E. Farber-Eger: None. Q.S. Wells: None. K.N. Bachmann: None. M. Xu: None. F. Harrell: None. D.K. Gupta: None. T.J. Wang: None.
- © 2016 by American Heart Association, Inc.