Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605866
Vorträge
Georg Thieme Verlag KG Stuttgart · New York

Longitudinal changes of N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) and total mortality in elderly people: the ActiFE Study

D Dallmeier
1   Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
2   Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
,
U Braisch
1   Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
2   Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
3   Ulm Universität, Inst. für Epidemiologie und medizinische Biometrie, Ulm
,
W Koenig
4   Ulm Universität, Innere Medizin II, Ulm
5   Deutsches Herzzentrum München, München
,
M Denkinger
1   Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
2   Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
,
D Rothenbacher
3   Ulm Universität, Inst. für Epidemiologie und medizinische Biometrie, Ulm
› Author Affiliations
Further Information

Publication History

Publication Date:
01 September 2017 (online)

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Background:

Baseline levels of N-Terminal pro Brain Natriuretic Peptide (NT-proBNP), an established biomarker of myocardial stress, have been independently associated with total mortality in elderly people. We evaluated if NT-proBNP changes were associated with 6-year mortality after adjustment for well-established confounders.

Methods:

NT-proBNP levels were measured at baseline and at the 3-year follow-up (FU) exam in community-dwelling adults ≥65 years, participants of the Activity and Function in the Elderly in Ulm study – ActiFE Ulm. We assessed the relative change of log-transformed (ln) NT-proBNP levels from baseline to FU exam and evaluated their association with 6-year total mortality adjusting for baseline levels of NT-proBNP, age, and sex (Model 1), followed by addition of body mass index, cardiovascular disease (myocardial infarction, heart failure or stroke), hypertension, cystatin C based glomerular filtration rate, hemoglobin, and C-reactive protein (Model 2).

Results:

Among 797 subjects (mean age at baseline 74.2 years, 59.2% men) we observed 62 deaths during a medium FU of 3.4 years after second blood drawn. The median relative change of ln NT-proBNP was 5.6% (Q1 – 2.2, Q3 14.3). There were 45 deaths in 543 subjects (68.1%) with an increment, and 17 deaths in 254 (31.9%) with a decrement in ln NT-proBNP levels without significant differences for survival among these two groups (Log-Rank 0.399). However, we detected a statistically significant association between ln NT-proBNP relative change as a continuous variable and mortality with a HR for every 10 percent increment of baseline ln NT-proBNP of 1.16 [95% CI 1.02, 1.33] in Model 1, and of 1.16 [95% CI 1.002, 1.35] in Model 2.

Conclusions:

Longitudinal increases of NT-proBNP may be associated with an increased risk for death in asymptomatic older individuals after adjustment for well-established confounders. To confirm this possible association bigger sample sizes and longer FU times are needed.