BNP and NT-proBNP, Predictors of 1-Year Mortality in Nursing Home Residents

Barents, Maaike; Hillege, Hans; Horst, Iwan C. C. van der; Boer, Rudolph A de; Koster, J.; Muskiet, Frits A. J.; Jongste, Mike J.L. de

doi:10.1016/j.jamda.2008.05.002

Cited by 17 publications

(9 citation statements)

References 28 publications

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“…BNP also predicts mortality in diabetes, 8 cardiac surgery patients, 9 and nursing home residents. 10 The current study demonstrates that NT-proBNP can reclassify 8.1% of stroke subjects into more accurate mortality risk groups. Whether this is clinically meaningful requires some consideration.…”

mentioning

confidence: 59%

Predicting stroke mortality

Jickling

Foerch

2013

Neurology

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Physicians, patients, and families rely on clinical factors associated with stroke mortality to guide decisions of care and set goals of medical therapy. However, these factors, including age and baseline neurologic impairment, are at best imperfect predictors and additional prognostic tools are needed. Biomarkers such as B-type natriuretic peptide (BNP) have potential. However, for a biomarker to be of clinical utility, it needs to add information beyond what clinical predictors can provide. BNP is produced by myocardial tissue in response to strain and acts to reduce systolic blood pressure through vasodilation and natriuresis. In stroke, BNP has been associated with increased mortality.

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mentioning

confidence: 59%

Predicting stroke mortality

Jickling

Foerch

2013

Neurology

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“…Barents et al [31] found that natriuretic peptides were predictors of 1-year mortality in residents of a nursing home, the association being independent from age, gender and comorbidity.…”

Section: Discussionmentioning

confidence: 99%

Relationship between N-Terminal Pro-B-Type Natriuretic Peptide Plasma Levels and Renal Function Evaluated with Different Formulae in Older Adult Subjects Admitted because of Dyspnea

Fabbian¹,

Giorgi²,

Portaluppi³

et al. 2011

Gerontology

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Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels are associated with congestive heart failure severity, and are an important diagnostic tool for assessing patients with acute dyspnea. Reduced renal function increases NT-proBNP concentrations, and therefore it might be a confounding factor in chronic kidney disease (CKD) patients. Objective: The aim of the present study was to relate NT-proBNP plasma levels to different stages of renal function assessed with different methods in older adult subjects admitted because of dyspnea. Methods: NT-proBNP plasma levels (Roche Diagnostic, Mannheim, Germany) were measured in 134 older adult patients (age: 80 ± 6 years) admitted to hospital because of dyspnea. Anthropometrics, anamnesis, and biochemical data were collected. Glomerular filtration rate (GFR) was evaluated with different equations, the 4 variables MDRD equations (GFR_MDRD186, GFR_MDRD175), Mayo Clinic Quadratic formula (GFR_MAYO), and the new CKD-EPI formula (GFR_CKD-EPI). Patients were classified into the five K/DOQI stages of CKD and median NT-proBNP values were calculated evaluating their relationship with GFR. Results: Median NT-proBNP values were better stratified into the five K/DOQI stages by GFR_MAYO (stage 1 (n = 10) 1,640 pg/ml vs. stage 2 (n = 61) 2,371 pg/ml vs. stage 3 (n = 42) 3,815 pg/ml vs. stage 4 (n = 18) 6,320 pg/ml vs. stage 5 (n = 3) 7,256 pg/ml, p = 0.017). However, similar results were obtained with the other formulae. NT-proBNP was negatively correlated with GFR as evaluated with all the different formulae (r –0.25 to –0.29; all p < 0.01). Multiple regression analysis confirmed the independent association between LnNT-proBNP and GFR. Conclusion: NT-proBNP plasma levels progressively increase with worsening of renal function, and appear to be related to the five K/DOQI stages of CKD. For this purpose, GFR assessed with the GFR_MAYO formula appears to better stratify NT-proBNP in older adult subjects. Renal function should be considered when interpreting NT-proBNP levels in older adult patients admitted for dyspnoea.

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“…So the lack of symptom specificity and the contribution of symptoms to aging lead often to an underdiagnosis of heart failure. Another problem is that diagnostic tests (B-type natriuretic peptide [BNP]) exclude but do not determine CHF in older adults with multimorbidity (Barents et al, 2008a(Barents et al, , 2008b. At last, echocardiography is not easily accessible.…”

Section: Of Lifementioning

confidence: 99%

“…Second, the CHF prevalence in residents and the CHF consequences on ADL ability were unknown. Results of the first two observations studied were described elsewhere (Barents et al, 2008a(Barents et al, , 2008b. Third, we knew that Dutch nursing home staff did not take CHF into account for care-level calculations.…”

Section: Of Lifementioning

confidence: 99%