TY - JOUR
T1 - Comparable prognostic impact of BNP levels among HFpEF, Borderline HFpEF and HFrEF
T2 - a report from the CHART-2 Study
AU - On behalf of the CHART-2 Investigators
AU - Kasahara, Shintaro
AU - Sakata, Yasuhiko
AU - Nochioka, Kotaro
AU - Yamauchi, Takeshi
AU - Onose, Takeo
AU - Tsuji, Kanako
AU - Abe, Ruri
AU - Oikawa, Takuya
AU - Sato, Masayuki
AU - Aoyanagi, Hajime
AU - Miura, Masanobu
AU - Shiroto, Takashi
AU - Takahashi, Jun
AU - Miyata, Satoshi
AU - Shimokawa, Hiroaki
N1 - Funding Information:
Funding This study was supported in part by the Grants-in Aid from the Japanese Ministry of Health, Labour, and Welfare and the Japanese Ministry of Education, Culture, Sports, Science, and Technology and the Agency for Medical Research and Development (nos. 15ek0210043h0001, 16ek0210056h0001, 6ek0210043h0002), Tokyo, Japan.
Funding Information:
cular Medicine, Tohoku University Graduate School of Medicine is supported in part by unrestricted research grants from Daiichi San-kyo (Tokyo, Japan), Bayer Yakuhin (Osaka, Japan), Kyowa Hakko Kirin (Tokyo, Japan), Novartis Pharma (Tokyo, Japan), Dainippon Sumitomo Pharma (Osaka, Japan), Astellas Pharma (Tokyo, Japan), AstraZeneca (Osaka, Japan), Chugai Pharmaceutical (Tokyo, Japan), GlaxoSmithKline (Tokyo, Japan), Kowa Pharmaceutical (Tokyo, Japan), Mitsubishi Tanabe Pharma (Osaka, Japan), Mochida Pharmaceutical (Tokyo, Japan), MSD (Tokyo, Japan), Nippon Boehringer Ingel-heim (Tokyo, Japan), Otsuka Pharmaceutical (Tokyo, Japan), Shionogi (Osaka, Japan) and Takeda Pharmaceutical (Osaka, Japan). H.S. has received lecture fees from Bayer Yakuhin (Osaka, Japan), Daiichi San-kyo (Tokyo, Japan) and Novartis Pharma (Tokyo, Japan).
Publisher Copyright:
© 2018, Springer Japan KK, part of Springer Nature.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - We aimed to compare the usefulness of plasma levels of B-type natriuretic peptide (BNP) for long-term risk stratification among patients with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HFpEF), borderline HFpEF, and HF with reduced LVEF (HFrEF) in the same HF cohort. In the CHART-2 Study (N = 10,219), we categorized 4301 consecutive Stage C/D HF patients (mean age 68.7 years, female 32.4%) into 3 groups: HFpEF (LVEF ≥ 50%, N = 2893), borderline HFpEF (LVEF 40–50%, N = 666), and HFrEF (LVEF ≤ 40%, N = 742). During the median 6.3-year follow-up, all-cause deaths occurred in 887 HFpEF, 330 borderline HFpEF, and 330 HFrEF patients. Although median BNP levels increased from HFpEF, borderline HFpEF to HFrEF (85.3, 126 and 208 pg/ml, respectively, P < 0.001), the relationship between log2 BNP levels and the mortality risk was comparable among the 3 groups. As compared with patients with BNP < 30 pg/ml, those with 30–99, 100–299 and ≥ 300 pg/ml had comparably increasing mortality risk among the 3 groups (hazard ratio 2.5, 4.7 and 7.8 in HFpEF, 2.1, 4.2 and 7.0 in borderline HFpEF, and 3.0, 4.7 and 9.5 in HFrEF, respectively, all P < 0.001). BNP levels have comparable prognostic impact among HFpEF, borderline HFpEF, and HFrEF patients.
AB - We aimed to compare the usefulness of plasma levels of B-type natriuretic peptide (BNP) for long-term risk stratification among patients with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HFpEF), borderline HFpEF, and HF with reduced LVEF (HFrEF) in the same HF cohort. In the CHART-2 Study (N = 10,219), we categorized 4301 consecutive Stage C/D HF patients (mean age 68.7 years, female 32.4%) into 3 groups: HFpEF (LVEF ≥ 50%, N = 2893), borderline HFpEF (LVEF 40–50%, N = 666), and HFrEF (LVEF ≤ 40%, N = 742). During the median 6.3-year follow-up, all-cause deaths occurred in 887 HFpEF, 330 borderline HFpEF, and 330 HFrEF patients. Although median BNP levels increased from HFpEF, borderline HFpEF to HFrEF (85.3, 126 and 208 pg/ml, respectively, P < 0.001), the relationship between log2 BNP levels and the mortality risk was comparable among the 3 groups. As compared with patients with BNP < 30 pg/ml, those with 30–99, 100–299 and ≥ 300 pg/ml had comparably increasing mortality risk among the 3 groups (hazard ratio 2.5, 4.7 and 7.8 in HFpEF, 2.1, 4.2 and 7.0 in borderline HFpEF, and 3.0, 4.7 and 9.5 in HFrEF, respectively, all P < 0.001). BNP levels have comparable prognostic impact among HFpEF, borderline HFpEF, and HFrEF patients.
KW - B-type natriuretic peptide
KW - Heart failure
KW - Left ventricular ejection fraction
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85044295116&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044295116&partnerID=8YFLogxK
U2 - 10.1007/s00380-018-1150-4
DO - 10.1007/s00380-018-1150-4
M3 - Article
C2 - 29569034
AN - SCOPUS:85044295116
SN - 0910-8327
VL - 33
SP - 997
EP - 1007
JO - Heart and Vessels
JF - Heart and Vessels
IS - 9
ER -