ABSTRACTS - Hypertension, Vascular Disease, and Prevention 269A 1201-81 N-Terminal Pro Brain Natrlureti¢ Peptide (NT-proBNP) Predicts Left Ventriculer Function and Mortality in Hemodlalysis Patients but Not Cardiac Death: A Two- Year Outcome Study Joseoh P. Lonohitano. William L. Henhch, Paul D. Light, Eric Tiblier, Heidi Sparger, Mathew M. Smilay, John Badalamenti, Juergen Trawinski, Christopher R. deFilippi, University of Maryland, Baltimore, Maryland, University of Texas Medical Branch, Galveston, Texas. NT-proBNP is a stable marker of left ventricular (LV) dysfunction in the general popula- tion, but its predictive value in patients on chronic hemodialysis (HD), a group with chronic volume overload as well as a large burden of ischemic heart disease and cardio- vascular death, is unknown. This prospective study of 224 HD patients was designed to learn the predictive value of NT-proBNP for death, LV function and the magnitude of CAD. HD pts from 5 HD centers (age 60±15 years, 54% male, 48% diabetic) in whom NT-proBNP levels (mean of two values, one month apart, normal 0.40 (9956±11420 vs. 4853±5940, p=0.0013). The Table depicts NT-proBNP by quartiies, and shows the corresponding mortality (%), depressed LVEF (%), mean LV mass, multives- sel CAD (%) and cardiac death or non-fatal MI (%). Overall mortality, LV dysfunction and LV mass increased with risifig NT-proBNP levels but NT-proBNP was not predictive of multivessel CAD or cardiac death. We conclude that NT-proBNP levels are high in most HD pts, and that levels >2800 pmol/ L are associated with a marked decrease in LVEF and risk of all cause mortality in a large percentage of pts but are not a marker of atheroscierotic burden or CV death, Quartile 1 2 3 4 pvaluefortrend NT-proBNP (pmol/L) 87-1246 1247-27662792-66986730-55164 Death (% pts) 23.2 23.2 46.4 44.6 0.006 LVEF< 0.40 (% pts) 2.6 9.8 22.6 27.3 0.008 LV mass (g/m 2) 130-~31 133+31 137±44 160±39 0.002 Multivessel CAD (% pts) 42.1 18.1 5.6 47.6 0.790 CV Death or Non-Fatal MI 16.1 17.9 16.1 22.6 0.450 (% pts)