Could An HF Biomarker Predict Mortality in the General Population, Too?

Elevated B-type natriuretic peptide (BNP) can not only predict mortality risk in patients with heart failure (HF), but also in those without HF, according to new findings.

Researchers arrived at this conclusion following a study of 30,487 participants whose data was available in the Vanderbilt University Medical Center electronic health record.
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All participants included in the study had a first plasma BNP measurement between 2002 and 2013, with follow-up through 2015.

Multivariate Cox proportional hazards models were used to quantify the risk for death.

A total of 5903 participants without HF (31%) and 6181 with HF (53%) died over the course of 90,898 person-years of follow-up.

Results of the study showed that, although BNP level was lower in participants without HF compared with those with HF (median 89 pg/ml vs 388 pg/ml), it was found to be one of the strongest predictors of death in both patients with and without HF.

Notably, the researchers found that mortality risk based on BNP was similar between individuals with and without HF in both acute care and outpatient settings, adding that a BNP level of 400 pg/ml was associated with a 3-year mortality risk of 21% and 19% in individuals with and without HF, respectively.

“Among patients without HF, plasma BNP level is a stronger predictor of death than traditional risk factors,” the researchers concluded. “The risk for death associated with any given BNP level is similar between patients with and those without HF, particularly in the acute care setting.”

—Christina Vogt

Reference:

York MK, Gupta DK, Reynolds CF, et al. B-type natriuretic peptide levels and mortality in patients with and without heart failure. J Am Coll Cardiol. 2018;71(19). doi:10.1016/j.jacc.2018.02.071

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