Incremental prognostic value of changes in B-type natriuretic peptide in heart failure

Roberto Latini, Serge Masson, Maylene Wong, Simona Barlera, Elisa Carretta, Lidia Staszewsky, Tarciso Vago, Aldo P. Maggioni, Inder S. Anand, Lip B. Tan, Gianni Tognoni, Jay N. Cohn

Research output: Contribution to journalArticlepeer-review


PURPOSE: B-type natriuretic peptide is one of the most sensitive and specific biohumoral markers of heart failure. We hypothesized that B-type natriuretic peptide changes during treatment of heart failure may provide independent information on disease progression and outcome in patients enrolled in the Val-HeFT trial. METHODS: Patients were divided into four groups according to concentrations of B-type natriuretic peptide at baseline versus 4 months (n = 3740) or 12 months (n = 3343), with respect to the baseline median (97 pg/mL): low→low (stable below median, 44%-46%), high→high (stable above median, 32%-37%), high→low (above to below median, 12%-14%), and low→high (below to above median, 6%-9%). Cox multivariate regression analysis was used to assess the risk of death and morbidity, with adjustment for baseline B-type natriuretic peptide concentrations. RESULTS: Patients who improved their B-type natriuretic peptide at 4 months (high→low) had a similar risk for mortality (hazard ratio = 1.191, 95% confidence interval [CI] 0.870-1.631, P =.2746) compared with the low→low patients. Conversely, patients who worsened in their B-type natriuretic peptide (low→high) had a risk for mortality (hazard ratio 2.578, CI, 1.861-3.571, P 2 increase in left ventricular end-diastolic diameter, whereas it decreased by 0.10 cm/m2 in high→low and low→low groups (P

Original languageEnglish
JournalAmerican Journal of Medicine
Issue number1
Publication statusPublished - Jan 2006


  • Brain natriuretic peptide
  • Heart failure
  • Prognosis
  • Trials

ASJC Scopus subject areas

  • Nursing(all)


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