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Background: Elevated NTproBNP has been associated with adverse outcomes in the community setting for at risk (Stage A Heart failure [HF]) patients. A recent study (STOP-HF) has implied potential mortality benefits of ACE inhibitors (ACEI)/ARBs or beta blockers (BB) in this population. We investigated the prevalence of elevated NTproBNP levels in outpatients without HF. We hypothesized that a significant portion of this population may be amenable to intervention for preventing HF
Methods: We manually reviewed records from 2007-14 of consecutive subjects at our preventive cardiology clinic where NTproBNP was routinely measured as part of the initial consult for risk factor modification. Elevated NTproBNP level was defined by ≥125pg/mL. Patients with HF were excluded. Variables for the Health ABC heart failure score (HABC) were extracted
Results: Of the 4145 patients with available NTproBNP, 1186 (33%) had elevated levels. In this cohort (mean age = 61.5±12.5years, 40% males, median [IQR] NTproBNP = 315[179-877]pg/mL), 961 (81%) had creatinine <1.2 mg/dL with median[IQR] NTproBNP = 228[IQR 173-664] pg/mL. Higher HABC score was associated with higher NTproBNP levels (p<0.01). 55% were not on ACEI/ARBs and 37% were not on BB
Conclusions: One third of the referrals to preventive cardiology clinic with Stage A HF had elevated NTproBNP and an increased HF risk, with a proportion not on ACEI/ARBs or BB. Future studies to determine whether this subset can be targeted for primary prevention of HF are warranted.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-294
- 2017 American College of Cardiology Foundation