Heart failure & cardiomyopathies
Setting the Optimal Threshold of NT-proBNP and BNP for the Diagnosis of Heart Failure in Patients Over 75 Years
Authors' conclusion
In older patients, we found significant effects of co-morbidities on natriuretic peptides results, particularly in patients over 85 years old, older patients with abnormal renal function, obesity, and atrial fibrillation. Despite the consideration of those co-morbid conditions, NT-proBNP and BNP level continue to demonstrate utility in the diagnosis of AHF in older patients.
Study context
- Population
- Hospitalised patients aged ≥75 years with acute dyspnoea and BNP or NT-proBNP measured within 48 h of admission, 10 Assistance Publique-Hôpitaux de Paris facilities, 2011–20227,946 (65.8%) with acute heart failure (AHF)
- Participants
- 12,071 patients
- Exposure
- NT-proBNP vs BNP
- Outcome
- Diagnostic thresholds of BNP and NT-proBNP for AHF (ICD-10 discharge diagnosis)
Methodological detailslongitudinal, multicentre
- Longitudinal
- Multicentre
Main finding
As reported in the abstract
Optimal NT-proBNP threshold for AHF diagnosis
| Group | Value | PPV |
|---|---|---|
| NT-proBNP | threshold 1748 ng/L | 84% |
NT-proBNP
Valuethreshold 1748 ng/L
PPV84%
Observational data: associations, not effects.
Further findings
| Outcome | NT-proBNP |
|---|---|
| AHF diagnosis, patients aged over 85 years (subgroup) | |
| Threshold | 2235 pg/mL |
| PPV | 84% |
| AHF diagnosis, patients with AF (subgroup) | |
| Threshold | 2332 pg/mL |
| PPV | 90% |
| AHF diagnosis, patients with eGFR < 30 mL/min (subgroup) | |
| Threshold | 3474 pg/mL |
| PPV | 90% |
AHF diagnosis, male patients (subgroup)
- Threshold
- 1800 pg/mL
- PPV for AHF diagnosis
- 85%
AHF diagnosis, patients with obesity (subgroup)
- Threshold
- 1375 pg/mL
- PPV for AHF diagnosis
- 85%
Original publication
Setting the Optimal Threshold of NT-proBNP and BNP for the Diagnosis of Heart Failure in Patients Over 75 Years. ESC Heart Fail. Published 24 June 2024. doi:10.
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