Michael Fulks1, Valerie Kaufman1, Michael Clark1, Robert L Stout1. 1. Michael Fulks, Clinical Reference Laboratory, Jackson, CA; Valerie Kaufman, RGA Reinsurance Company, Chesterfield, MO; Michael Clark, Penn Mutual Life Insurance Company, Horsham, PA; Robert L. Stout, Clinical Reference Laboratory, Lenexa, KS.
Abstract
OBJECTIVE: - Further refine the independent value of NT-proBNP, accounting for the impact of other test results, in predicting all-cause mortality for individual life insurance applicants with and without heart disease. METHOD: - Using the Social Security Death Master File and multivariate analysis, relative mortality was determined for 245,322 life insurance applicants ages 50 to 89 tested for NT-proBNP (almost all based on age and policy amount) along with other laboratory tests and measurement of blood pressure and BMI. RESULTS: - NT-proBNP values ≤75 pg/mL included the majority of applicants denying heart disease and had the lowest risk, while values >500 pg/mL for females and >300 pg/mL for males had very high relative risk. Those admitting to heart disease had a higher mortality risk for each band of NT-proBNP relative to those denying heart disease but had a similar and equally predictive risk curve. CONCLUSION: - NT-proBNP is a strong independent predictor of all-cause mortality in the absence or presence of known heart disease but the range of values associated with increased risk varies by sex.
OBJECTIVE: - Further refine the independent value of NT-proBNP, accounting for the impact of other test results, in predicting all-cause mortality for individual life insurance applicants with and without heart disease. METHOD: - Using the Social Security Death Master File and multivariate analysis, relative mortality was determined for 245,322 life insurance applicants ages 50 to 89 tested for NT-proBNP (almost all based on age and policy amount) along with other laboratory tests and measurement of blood pressure and BMI. RESULTS: - NT-proBNP values ≤75 pg/mL included the majority of applicants denying heart disease and had the lowest risk, while values >500 pg/mL for females and >300 pg/mL for males had very high relative risk. Those admitting to heart disease had a higher mortality risk for each band of NT-proBNP relative to those denying heart disease but had a similar and equally predictive risk curve. CONCLUSION: - NT-proBNP is a strong independent predictor of all-cause mortality in the absence or presence of known heart disease but the range of values associated with increased risk varies by sex.
Entities:
Keywords:
Cardiovascular disease; NT-proBNP; laboratory tests; life insurance; mortality
Authors: Marcus V B Malachias; Pardeep S Jhund; Brian L Claggett; Magnus O Wijkman; Rhonda Bentley-Lewis; Nishi Chaturvedi; Akshay S Desai; Steven M Haffner; Hans-Henrik Parving; Margaret F Prescott; Scott D Solomon; Dick De Zeeuw; John J V McMurray; Marc A Pfeffer Journal: J Am Heart Assoc Date: 2020-09-23 Impact factor: 5.501