Usefulness of N-Terminal Pro-Brain Natriuretic Peptide to Predict Mortality in Adults With Congenital Heart Disease

作者：Popelova Jana Rubackova^*; Kotaska Karel; Tomkova Marketa; Tomek Jakub

来源：American Journal of Cardiology, 2015, 116(9): 1425-1430.

DOI：10.1016/j.amjcard.2015.07.070

Natriuretic peptides are often elevated in congenital heart disease (CHD); however, the clinical impact on mortality is unclear. The aim of our study was to evaluate the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the prediction of all-cause mortality in adults with different CHD. In this prospective longitudinal mortality study, we evaluated NT-proBNP in 1,242 blood samples from 646 outpatient adults with stable CHD (mean age 35 12 years; 345 women). Patients were followed up for 6 3 (1 to 10) years. The mortality rate was 5% (35 patients, mean age 40 14 years, 17 women). Median NT-proBNP (pg/ml) was 220 in the whole cohort, 203 in survivors, and 1,548 in deceased patients. The best discrimination value for mortality prediction was 630 pg/ml with 74% sensitivity and 84% specificity. During the follow-up, the survival rate was 65% for those with median NT-proBNP >= 630 pg/ml and 94% for NT-proBNP <630 pg/ml; p < 0.0001. There was only 1% mortality among 388 patients with at least 1 NT-proBNP value <= 220 pg/ml compared with 41% mortality among 54 patients with at least 1 NT-proBNP value >1,548 pg/ml. Even the first (baseline) measurements of NT-proBNP were strongly associated with a high risk of death (log(10) NT-proBNP had hazard ratio 7, p < 0.0001). In conclusion, NT-proBNP assessment is a useful and simple tool for the prediction of mortality in long-term follow-up of adults with CHD.

• 出版日期2015-11-1