Accuracy of N-terminal pro-brain natriuretic peptide to predict mortality in various subsets of patients with coronary artery disease.

The ability of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) to predict mortality in various subsets of patients with coronary artery disease (CAD) is not known. The aim of present study was to investigate the ability of NT-pro-BNP to predict mortality in various subsets of patients with CAD. The study included 1,552 consecutive patients with angiographically proven CAD. Based on receiver-operating characteristic curve analysis, the best NT-pro-BNP level for mortality prediction was 721 ng/L (sensitivity 71.3%, specificity 71.3%). Patients were divided into 2 groups: the group with NT-pro-BNP level < or =721 ng/L (1,034 patients) and the group with NT-pro-BNP level >721 ng/L (518 patients). The primary end point of the study was mortality. The median follow-up was 3.6 years (interquartile range 3.3 to 4.6). In total there were 171 deaths: 49 deaths in the group with NT-pro-BNP < or =721 ng/L and 122 deaths in the group with NT-pro-BNP >721 ng/L (mortality estimates 6.6% vs 29.5%, odds ratio 5.2; 95% confidence intervals 3.9 to 7.0, p <0.001). In 28 subsets of patients, NT-pro-BNP level predicted mortality with odds ratio varying from 2.8 to 7.5. In conclusion, NT-pro-BNP is a reliable predictive marker of mortality in all subsets of patients with CAD.