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Increase in N-terminal pro-brain natriuretic peptide levels, renal function and cardiac disease in the oldest old.
- Source :
-
Age & Ageing . Sep2015, Vol. 44 Issue 5, p841-847. 7p. - Publication Year :
- 2015
-
Abstract
- Background: the impact of renal function and its changes and the occurrence of cardiovascular events on changes in N-terminal pro-brain natriuretic peptide levels (NT-proBNP) is unknown in very old age. Objective: to assess whether increase in NT-proBNP levels over time is still associated with cardiac disease and mortality in very old age, independent of renal function. Methods: changes in NT-proBNP levels between age 85 and 90 years and their associations with incident cardiac disease, (cardiovascular) mortality and renal function were assessed in 252 nonagenarian participants from a population-based sample of the Leiden 85-plus Study. Results: median NT-proBNP increase over 5 years was 154 pg/ml (inter-quartile range: 29-549), while in the same period estimated glomerular filtration rate (eGFR) decreased by 5.8 ml/min/1.73 m2 (standard deviation 7.5). Participants with increasing NT-proBNP levels more frequently developed heart failure and atrial fibrillation (odds ratio 2.79, 95% confidence interval (CI) 1.11-7.02 and 2.63, 95% CI 1.02-6.79, respectively, adjusted for eGFR at age 85 and change in eGFR) between age 85 and 90 years. Increasing NT-proBNP levels between age 85 and 90 years were associated with an increased cardiovascular mortality risk after age 90 years compared with not-increasing NT-proBNP levels (hazard ratio 1.62, 95% CI 1.04-2.51, adjusted for eGFR at age 90 years and change in eGFR). Conclusion: in the oldest old, increase in NT-proBNP is associated with incident heart failure and atrial fibrillation and risk for cardiovascular mortality, independent of decreasing renal function. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ATRIAL fibrillation risk factors
*HEART failure risk factors
*CARDIOVASCULAR diseases
*CONFIDENCE intervals
*CREATININE
*GLOMERULAR filtration rate
*KIDNEY function tests
*LONGITUDINAL method
*PATIENTS
*PEPTIDE hormones
*PROBABILITY theory
*RESEARCH funding
*T-test (Statistics)
*LOGISTIC regression analysis
*DATA analysis software
*DESCRIPTIVE statistics
*KAPLAN-Meier estimator
*ODDS ratio
CARDIOVASCULAR disease related mortality
Subjects
Details
- Language :
- English
- ISSN :
- 00020729
- Volume :
- 44
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Age & Ageing
- Publication Type :
- Academic Journal
- Accession number :
- 110181326
- Full Text :
- https://doi.org/10.1093/ageing/afv091