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Prognostic power of NT-proBNP in left ventricular non-compaction cardiomyopathy


Stämpfli, Simon F; Erhart, Ladina; Hagenbuch, Niels; Stähli, Barbara E; Gruner, Christiane; Greutmann, Matthias; Niemann, Markus; Kaufmann, Beat A; Jenni, Rolf; Held, Leonhard; Tanner, Felix C (2017). Prognostic power of NT-proBNP in left ventricular non-compaction cardiomyopathy. International Journal of Cardiology, 236:321-327.

Abstract

Background: The risk of adverse events in patients with left ventricular non-compaction cardiomyopathy (LVNC) is substantial. This study was designed to determine the prognostic value of NT-proBNP, left ventricular ejection fraction (LVEF), NYHA class, and exercise capacity in LVNC patients.
Methods: Cox regression analyses were performed for evaluating the prognostic value of NT-proBNP, LVEF, NYHA class, and exercise capacity on the occurrence of death or heart transplantation. 153 patients were included.
Results: During 1013 person-years (longest follow-up 18.5 years) 23 patients (15%) died or underwent heart transplantation. We observed a significant relationship of NT-proBNP (adjusted HR 2.44, 95% CI 1.45–4.09, for every NT-proBNP doubling, p = 0.0007) and LVEF (adjusted HR for age 60 years: 2.68, 95% CI 1.62–4.41, p = 0.0001) with the risk of death or heart transplantation. Combined covariate analysis indicated a strong influence of NT-proBNP (adjusted 2.89, 95% CI 1.33–6.26, p = 0.007), whereas LVEF was no longer significant (adjusted HR 0.82, 95% CI 0.42–1.67, p = 0.66) demonstrating a favorable prognostic power of NT-proBNP over LVEF. An increase in NYHA class was associated with a worse outcome, and exercise capacity revealed a trend in the same direction. For all the abovementioned analyses, similar results were obtained when assessing the values at first presentation.
Conclusion: This study provides evidence that an increase in NT-proBNP is a strong predictor of outcome in patients with LVNC. The prognostic power of NT-proBNP is at least as good as that of LVEF, indicating that routine NT-proBNP measurement may improve risk assessment in LVNC.

Abstract

Background: The risk of adverse events in patients with left ventricular non-compaction cardiomyopathy (LVNC) is substantial. This study was designed to determine the prognostic value of NT-proBNP, left ventricular ejection fraction (LVEF), NYHA class, and exercise capacity in LVNC patients.
Methods: Cox regression analyses were performed for evaluating the prognostic value of NT-proBNP, LVEF, NYHA class, and exercise capacity on the occurrence of death or heart transplantation. 153 patients were included.
Results: During 1013 person-years (longest follow-up 18.5 years) 23 patients (15%) died or underwent heart transplantation. We observed a significant relationship of NT-proBNP (adjusted HR 2.44, 95% CI 1.45–4.09, for every NT-proBNP doubling, p = 0.0007) and LVEF (adjusted HR for age 60 years: 2.68, 95% CI 1.62–4.41, p = 0.0001) with the risk of death or heart transplantation. Combined covariate analysis indicated a strong influence of NT-proBNP (adjusted 2.89, 95% CI 1.33–6.26, p = 0.007), whereas LVEF was no longer significant (adjusted HR 0.82, 95% CI 0.42–1.67, p = 0.66) demonstrating a favorable prognostic power of NT-proBNP over LVEF. An increase in NYHA class was associated with a worse outcome, and exercise capacity revealed a trend in the same direction. For all the abovementioned analyses, similar results were obtained when assessing the values at first presentation.
Conclusion: This study provides evidence that an increase in NT-proBNP is a strong predictor of outcome in patients with LVNC. The prognostic power of NT-proBNP is at least as good as that of LVEF, indicating that routine NT-proBNP measurement may improve risk assessment in LVNC.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2017
Deposited On:30 Jan 2018 21:33
Last Modified:01 Mar 2018 19:02
Publisher:Elsevier
ISSN:0167-5273
OA Status:Green
Publisher DOI:https://doi.org/10.1016/j.ijcard.2017.02.064
PubMed ID:28268080

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