Abstract
Abstract Background Natriuretic peptides (NPs) are widely used in the diagnosis and risk stratification of heart failure (HF).NPs may have a reduced discriminative ability in the subgroup of elderly patients. Methods We examined all biological tests performed from February 2010 to August 2015 in two districts in the French Brittany. We report the “real-world” use of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in an elderly population and examine the measured concentration and potential impact of the cut-off value's selection. Results From a total of 3,606,432 tests ordered in 557,650 adult patients, 56,653 included at least one NT-proBNP measurement. NT-proBNP measurements gradually increased by 10-y age categories up to 80–90 y, and 39,828 (70.3%) of all measurements have been done in patients ≥75y. NT-proBNP concentrations increased with advanced age (Pearson's correlation coefficient: 0.2; p<10–5), with concentrations of 3,564±6,440 ng/L in patients ≥75y. NT-proBNP was inversely correlated with creatinine clearance (p<10–5). Respective proportions of NT-proBNP below the threshold value were 22.6% in patients aged 70 to 80y and less than 10% in those over 80 y when considering a single threshold value of 125 ng/L, and 31% and 33% in the same groups when considering a dual age-adjusted threshold value of 450 ng/L in patients >75y (p<0.001 for all comparisons). Conclusion Among a very large cohort, we observed that NT-proBNP is increasingly measured in elderly patients. NT-proBNP concentrations increase with age, and the selection of the threshold value markedly impacts the proportion of “low” versus “high” results. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Roche Diagnostics Proportion (in %) of low NT-proBNP
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