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Comparison of the Diagnostic Accuracy of Plasma N-Terminal Pro-Brain Natriuretic Peptide in Patients 80 Years of Age with Heart Failure

Research output: Contribution to journalArticle

Original languageEnglish
JournalAmerican Journal of Cardiology
Early online date13 Sep 2018
DOIs
Publication statusE-pub ahead of print - 13 Sep 2018

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Abstract

Plasma N-Terminal Pro-Brain Natriuretic Peptide (NTproBNP) is known to increase with age however the performance of this biomaker is unclear in patients >80. This study sought to define the diagnostic accuracy of plasma NTproBNP in patients > 80 in a large unselected population of heart failure (HF) patients admitted to a Tertiary Hospital in the United Kingdom. 1995 consecutive patients over a 12 month period were screened for HF through our NTproBNP led heart failure service. 413 patients had their first presentation of HF and 36.1% of these patients were > 80. There was a reduction in accuracy of NTproBNP with age according to the Area under the curve (AUC), with an AUC for all HF patients of 0.734 and a 7.5% reduction in receiver operating characteristic curve (ROC) area for patients > 80 years compared to those under 60-79 years of age. The lowest NTproBNP recorded for patients with HF > 80 years of age was 466pg/mL. In HF patients > 80, 40.6% patients were diagnosed with HFrEF, 31.1% with HFpEF and 28.2% with HFmrEF. Overall NTproBNP is less accurate at identifying HF in patients > 80 years of age and the lowest NTproBNP recorded for a HF patient was 466pg/mL suggesting that the NTproBNP threshold for ruling out HF in patients >80 years of age should be modified.

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