Literature DB >> 19083292

BNP and NT-proBNP, predictors of 1-year mortality in nursing home residents.

Maaike Barents1, Hans H L Hillege, Iwan C C van der Horst, Rudolph A de Boer, J Koster, Frits A J Muskiet, Mike J L de Jongste.   

Abstract

OBJECTIVES: To investigate 1-year mortality prediction of B type natriuretic peptide (BNP) and N terminal-proBNP (NT-proBNP) in institutionalized elderly with multiple morbidities.
DESIGN: Prospective cross-sectional study.
SETTING: One nursing home. PARTICIPANTS: Ninety-three residents (mean age 81 +/- 3 years, 66% female). Residents with serious cognitive impairments, aphasia, or metastatic cancer were excluded. MEASUREMENTS: Clinical assessment, immobilization, medical history, electrocardiogram (ECG), echocardiogram, blood samples. One general geriatrician assessed noncardiovascular diseases; a cardiologist panel established the diagnosis of chronic heart failure (CHF). Subjects were tracked for 1 year as far as status of death. MAIN
RESULTS: Eighteen of 93 enrolled individuals died. BNP was significantly higher in nonsurvivors compared with survivors (138 [49-753] versus 87 [27-162], P = .029), NT-proBNP was higher but did not reach significance 1382 (193-5683) versus 335 (175-900) pg/mL (interquartile range [IQR], P = .059). The adjusted value on 1-year mortality of 6 predefined chronic diseases, immobilization, age, sex, NT-proBNP, and BNP was estimated by means of Cox proportional hazard regression analyses. Finally, both for NT-proBP and BNP, a mutually adjusted multivariate Cox proportional hazard analysis with the covariates presented that BNP and NT-proBNP predicted 1-year mortality significantly (hazard ratio [HR] 1.67 and P = .000, HR 0.60 and P = .000, respectively). The mortality risk increased at rising BNP and NT-proBNP levels.
CONCLUSION: BNP and NT-proBNP are predictors of 1-year mortality independently of age, gender, and morbidity. The mortality risk increases at elevating natriuretic peptide concentrations. We postulate that plasma levels of BNP and NT-proBNP are also of use to predict prognosis in institutionalized elderly with multiple morbidity.

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Year:  2008        PMID: 19083292     DOI: 10.1016/j.jamda.2008.05.002

Source DB:  PubMed          Journal:  J Am Med Dir Assoc        ISSN: 1525-8610            Impact factor:   4.669


  4 in total

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  4 in total

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