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    Prediction of heart failure by serum amino-terminal-pro-b-type natriuretic peptide (nt-probnp): an interim analysis of the screening evaluation of the evolution of new heart failure (screen-hf) study

    Access Status
    Fulltext not available
    Authors
    Campbell, D.
    McGrady, M.
    Prior, D.
    Coller, J.
    Sheil, L.
    Boffa, U.
    Wolfe, R.
    Reid, Christopher
    Krum, H.
    Date
    2015
    Type
    Conference Paper
    
    Metadata
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    Citation
    Campbell, D. and McGrady, M. and Prior, D. and Coller, J. and Sheil, L. and Boffa, U. and Wolfe, R. et al. 2015. Prediction of heart failure by serum amino-terminal-pro-b-type natriuretic peptide (nt-probnp): an interim analysis of the screening evaluation of the evolution of new heart failure (screen-hf) study, in Morris, B.J. (ed), 36th Annual Scientific Meeting of the High Blood Pressure Research Council of Australia, Nov 26-28 2014, pp. E26-E27. Adelaide, Australia: Lippincott Williams & Wilkins.
    Source Title
    Abstracts From the 36th Annual Scientific Meeting of the High Blood Pressure Research Council of Australia
    Source Conference
    36th Annual Scientific Meeting of the High Blood Pressure Research Council of Australia
    ISSN
    0194-911X
    URI
    http://hdl.handle.net/20.500.11937/8304
    Collection
    • Curtin Research Publications
    Abstract

    Serum NT-proBNP level predicts heart failure. The SCREEN-HF study is a community-based cohort study that aims to identify an appropriate threshold NT-proBNP level for stratification of individuals into high and low risk for heart failure. Aim: To assess whether serum NT-proBPN level can predict heart failure risk in an at-risk population. Methods: We recruited people with at least one risk factor for heart failure: age ≥60 years with one or more of self-reported myocardial infarction or other ischemic or valvular heart disease, arrhythmia, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known heart failure or left ventricular dysfunction on previous cardiac imaging. Blood was collected from all participants at baseline for measurement of electrolytes, creatinine and NT-proBNP. Median age of the 3938 participants (2171 men and 1767 women) was 70 years (interquartile range 65–75), 83% were receiving treatment for hypertension, 18% were diabetic, 23% had ischemic heart disease (IHD), 11% had cerebrovascular disease, 10% had atrial fibrillation (AF), 32% had body mass index (BMI) >30 kg/m2, 7% had obstructive sleep apnoea (OSA), and 23% had glomerular filtration rate <60 mL/min/1.73 m2.Results: At the time of this interim analysis there were 77 cases of incident heart failure (49 men and 28 women) during a median follow-up of 6 years (incidence rate 3.3 per 1000 person years). Relative to NT-proBNP tertile 1, the odds ratio for incident heart failure was 4.0 (95% confidence interval: 1.1–14.4) for tertile 2 and 21.6 (6.8–69.0) for tertile 3. The C-statistic from receiver operating characteristic analysis was 0.81 (0.77–0.86), with similar values for men and women. NT-proBNP >18 pmol/L (the highest 35%) predicted incident heart failure with 80.5% sensitivity, 66.2% specificity, positive predictive value 4.5% and negative predictive value 99.4%. Although age, diabetes, IHD, AF, BMI and OSA were significant predictors of incident heart failure in a multivariable logistic regression model including NT-proBNP, none improved classification of heart failure risk beyond NT-proBNP alone. Among 3046 participants who had echocardiography, NT-proBNP >18 pmol/L predicted left ventricular ejection fraction (LVEF) <45% with 74% sensitivity and LVEF <40% with 79% sensitivity. Conclusions: Serum NT-proBNP level assists stratification of heart failure risk among a community population with risk factors for heart failure. Improved identification of individuals at increased risk of heart failure will enable targeting of preventative therapies.

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    • Prediction of incident heart failure by serum amino-terminal pro-B-type natriuretic peptide level in a community-based cohort
      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. (2019)
      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 ...
    • Amino-terminal-pro-B-type natriuretic peptide levels and low diastolic blood pressure: Potential relevance to the diastolic J-curve
      Campbell, D.; McGrady, M.; Prior, D.; Coller, J.; Boffa, U.; Shiel, L.; Liew, D.; Wolfe, R.; Stewart, S.; Reid, Christopher; Krum, H. (2014)
      Background: There is debate whether the J-curve relationship between cardiac event risk and DBP is because of inherent cardiac risk or is a consequence of blood pressure (BP) lowering therapy. Methods: We examined the ...
    • NT-proB natriuretic peptide, risk factors and asymptomatic left ventricular dysfunction: Results of the SCReening Evaluation of the Evolution of New Heart Failure Study (SCREEN-HF)
      McGrady, M.; Reid, Christopher; Shiel, L.; Wolfe, R.; Boffa, U.; Liew, D.; Campbell, D.; Prior, D.; Stewart, S.; Krum, H. (2013)
      Background We assessed left ventricular dysfunction in a population at high risk for heart failure (HF), and explored associations between ventricular function, HF risk factors and NT-proB natriuretic peptide (NT-proBNP). ...
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