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European Journal of Heart Failure 2008 10(3):315-320; doi:10.1016/j.ejheart.2008.01.009
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© 2008 European Society of Cardiology

Prognostic impact of NT-proBNP and renal function in comparison to contemporary multi-marker risk scores in heart failure patients

Roman Pfistera,*, Holger Diedrichsa, Anne Schiedermaira, Stephan Rosenkranza, Martin Hellmichb, Erland Erdmanna and Christian Alfons Schneidera

a Department III of Internal Medicine, University of Cologne Germany
b Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne Germany

* Corresponding author. Department III of Internal Medicine University of Cologne, Kerpener Str. 62, 50924 Cologne, Germany. Tel.: +49 221 478 5382; fax: +49 221 478 6574. E-mail address: roman.pfister{at}uk-koeln.de (R. Pfister).


  Abstract

Background: Multi-marker risk scores accurately predict prognosis in heart failure patients but calculation is complex.

Aims: To compare the prognostic accuracy of the Seattle Heart Failure Survival Score (SHFS) and a model derived from the CHARM programme, with laboratory parameters NT-proBNP and glomerular filtration rate (GFR).

Methods and results: In a sample of 290 heart failure patients, 39 patients died, 22 were hospitalised with acute heart failure and 4 underwent urgent cardiac transplantation during a median follow-up of 498 days. NT-proBNP, GFR, CHARM and SHFS showed an AUC for an endpoint during 1-year of 0.80, 0.72, 0.79 and 0.69, respectively. The hazard ratio for an endpoint during follow-up was 2.1, 2.6, 1.9 and 2.1 per 1 SD increase of log NT-proBNP and CHARM and per 1 SD decrease of GFR and SHFS, respectively. In multivariate analysis, log NT-proBNP and GFR added independent prognostic information to CHARM and SHFS, respectively.

Conclusion: NT-proBNP and GFR independently predicted endpoint-free survival in systolic heart failure patients, with NT-proBNP being superior and equally predictive to the SHFS and CHARM score, respectively. Assessment of both laboratory markers can simplify prognostic stratification, addition to multi-marker scores should be evaluated.

Key Words: Heart failure • Prognosis • NT-proBNP • Renal function • Seattle Heart Failure Model • CHARM model

Received August 8, 2007; Revised November 26, 2007; Accepted January 16, 2008


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