The significance of serum NT-proBNP determination for the death risk evaluation in elderly patients with chronic disease in five years

Abstract

Objective To explore the significance of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) for the death risk evaluation in elderly patients with chronic disease in five years. Methods A total of 765 elderly patients with chronic disease[136 patients with coronary heart disease (CHD), 76 patients with hypertension disease (HD), 86 patients with chronic obstructive pulmonary disease (COPD), 75 patients with Type 2 diabetic mellitus (T2DM), 76 patients with cerebral infarction (CI), 73 patients with coronary heart disease combined with hypertension, 71 patients with coronary heart disease combined with chronic obstructive pulmonary disease, 61 patients with coronary heart disease combined with diabetic, 51 patients with coronary heart disease combined with cerebral infarction, and 60 patients with three comorbidity] were classified into the survival group (312 cases) and the death group (453 cases) according to disease prognosis. The serum NT-proBNP levels of 88 healthy controls and 765 elderly patients with chronic disease were determined by bi-directional lateral flow immunoassay. The death events were followed up and observed for an average of 5 years. The results were analyzed statistically. Results The serum NT-proBNP levels in the death group with various diseases were significantly higher than the survival group (P 0.05). The serum NT-proBNP levels, the patient's age and the Proportion of male in the death group with various elderly chronic diseases had no statistical significance (P>0.05). The serum NT-proBNP levels in the death group with various elderly chronic diseases had no statistical significance (P>0.05), and were significantly higher than the survival group (P 0.05). The serum NT-proBNP levels in the death group in the different periods had statistical significance (P<0.01), and were significantly higher than the survival group and healthy control group (P<0.01). The more shorter of the survival time was, the higher the serum NT-proBNP leve was . The serum NT-proBNP levels were negatively correlated with the survival time of the patients (r=-0.378, P=0.000). The receiver operator characteristic (ROC) curve indicated that the optimal cut-off values of serum NT-proBNP levels for the death risk evaluation in elder patients with chronic disease were 1 499.50 ng/L. Kaplan-Meier survival curve showed that the survival rates of serum NT-proBNP levels had significant difference (P<0.01). The higher the serum NT-proBNP level was, the more shorter of the Survival rates were. Conclusions The levels of serum NT-proBNP have an important prognostic value in the death risk evaluation in elderly patients with various chronic disease. It is an independent risk factor for the death occurred in elderly patients with chronic disease. The levels of serum NT-proBNP are closely correlated with the survival rates and survival time of elderly patients, It can be used as a monitoring indicator of the elderly patients with chronic disease in risk stratification. Key words: Natriuretic peptide, brain/ME; Chronic disease; Death