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    Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort

    Access Status
    Fulltext not available
    Authors
    Campbell, D.
    Gong, F.
    Jelinek, M.
    Castro, J.
    Coller, J.
    McGrady, M.
    Boffa, U.
    Shiel, L.
    Wang, B.
    Liew, D.
    Wolfe, R.
    Stewart, S.
    Owen, A.
    Krum, H.
    Reid, Christopher
    Prior, D.
    Date
    2019
    Type
    Journal Article
    
    Metadata
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    Citation
    Campbell, D. and Gong, F. and Jelinek, M. and Castro, J. and Coller, J. and McGrady, M. and Boffa, U. et al. 2019. Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort. European Journal of Heart Failure. 21 (4): pp. 449-459.
    Source Title
    European Journal of Heart Failure
    DOI
    10.1002/ejhf.1381
    ISSN
    1388-9842
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/74000
    Collection
    • Curtin Research Publications
    Abstract

    Aims: We investigated which serum amino-terminal pro-B-type-natriuretic peptide (NT-proBNP) levels inform heart failure (HF) risk in a community-based population at increased cardiovascular disease (CVD) risk. Methods and results: Inclusion criteria were age = 60 years with one or more of self-reported hypertension, diabetes, heart disease, abnormal heart rhythm, cerebrovascular disease, or renal impairment. Exclusion criteria were known HF, ejection fraction (EF) < 50%, or more than mild valve abnormality. NT-proBNP levels were measured in 3842 participants on enrolment. HF was diagnosed in 162 participants at a median of 4.5 (interquartile range 2.7–5.4) years after enrolment, 73 with HF with preserved EF (HFpEF), 53 with HF with reduced EF (HFrEF), and 36 with valvular HF (VHF). Areas under the receiver operating characteristic curve (AUC) for 5-year prediction of total HF were similar for NT-proBNP alone (0.79, 95% confidence interval 0.74–0.83) and a 7-parameter multivariable model (0.82, 0.77–0.86, P = 0.035). NT-proBNP cut-points of 11, 16, and 25 pmol/L for individuals aged 60–69, 70–79, and = 80 years, respectively, achieved sensitivities > 76% and specificities of 47–69% for 5-year prediction of total HF in men and women in all three age groups. Sensitivities were = 75% in most subgroups according to body mass index, estimated glomerular filtration rate, and the presence or absence of atrial fibrillation, pacemaker, or CVD, and for the prediction of HFpEF, HFrEF and VHF. Conclusion: Age-specific serum NT-proBNP levels inform prognosis, and hence therapeutic decisions, regarding HF risk in individuals at increased CVD risk.

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