Evidence supporting the role of longitudinal NT-proBNP assessment for risk stratification in adults with congenital heart disease
Authors' conclusion
NT-proBNP assay is inexpensive, readily available, and noninvasive, making it ideal for longitudinal monitoring. Further studies are required to determine whether interventions that modify the correlates of NT-proBNP level would improve clinical outcomes in this population.
Study context
- Population
- Adults with congenital heart disease (CHD) with ≥2 NT-proBNP measurements (2003–2023)
- Participants
- 4,307 adults
- Exposure
- Serial NT-proBNP levels vs single NT-proBNP measurements
- Derivation cohortn = 2,154
- Validation cohortn = 2,153
- Outcome
- Baseline and follow-up NT-proBNP levels (derivation cohort)
Main finding
As reported in the abstract
Baseline NT-proBNP
189 (77, 538) pg/mL
Follow-up NT-proBNP
285 (127, 852) pg/mL
Temporal increase in NT-proBNP levels (relative ∆_NT-proBNP >0)
1481
69%
Observational data: associations, not effects.
Further findings
Correlates of higher baseline NT-proBNP
- Higher baseline NT-proBNP levels correlated with older age, atrial fibrillation, hepatorenal dysfunction, biventricular systolic dysfunction, and elevated biventricular filling pressures
Mortality
- Higher baseline NT-proBNP levels and temporal increase in NT-proBNP levels were associated with mortality
- Serial NT-proBNP levels had superior prognostic value compared to single (baseline) NT-proBNP measurements
Prognostic performance
- Prognostic performance of NT proBNP comparable to cardiac catheterization and exercise test indices, both in the derivation and validation cohorts
Original publication
Evidence supporting the role of longitudinal NT-proBNP assessment for risk stratification in adults with congenital heart disease. Am Heart J. Published 26 January 2026. doi:10.
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