Urinary NT-proBNP compared head-to-head to plasmatic NT-proBNP in a real life collective with an ICD.

Plasma NT-proBNP is an established marker of heart failure. Previous studies suggested urinary NT-proBNP has potential as marker of chronic heart failure as well. The objective of this study was to compare urinary NT-proBNP to plasma NT-proBNP in a real-life collective of patients with an ICD, especially regarding ICD-therapies. NT-proBNP was assessed in plasma and fresh spot urine (the latter related to urinary creatinine) from 322 patients of our ICD outpatient clinic. 54 healthy individuals served as a control group. Follow-up regarding mortality and ICD therapies was performed after 32 months (IQR 5-35 months). Plasma and urinary NT-proBNP was positively correlated (r = 0.89, p < 0,001). According to ROC analysis urinary NT-proBNP detected LV dysfunction (EF<35 % vs. healthy CTRL) with very satisfying predictive values (AUC 0.95), but plasma NT-proBNP showed slightly better values (AUC 0.99). Patients who received appropriate ICD-shock-therapies showed significantly higher plasma (p < 0.001) as well as urinary NT-proBNP levels (p = 0.011) compared to patients without shock-therapy. In Kaplan-Meier analysis, plasma as well as urinary NT-proBNP levels > Youden-Index showed significantly higher event rates for appropriate ICD-shock therapies (p < 0.001 and p = 0.016) and the combined endpoint of all-cause-mortality and shock therapies (each p < 0.001). Urinary and plasma NT-proBNP were independent predictors for appropriate ICD-shock-therapies and for the combined endpoint of all-cause mortality and appropriate ICD-shock-therapies (each p < 0.001). Urinary NT-proBNP as a marker for LV dysfunction and symptomatic heart failure showed promising predictive values. Associations between plasma as well as urinary NT-proBNP and ICD shock-therapies could be shown. Copyright © 2024 Indian Heart Rhythm Society. Published by Elsevier B.V. All rights reserved.

Citation

Benedikt Seither, Alexander Schober, Raphael Allgaier, Christine Meindl, Michael Paulus, Ute Hubauer, Andreas Schober, Ekrem Ücer, Sabine Fredersdorf, Petra Lehn, Andreas Keyser, Andreas Luchner, Lars Maier, Stefan Wallner, Carsten Jungbauer. Urinary NT-proBNP compared head-to-head to plasmatic NT-proBNP in a real life collective with an ICD. Indian pacing and electrophysiology journal. 2024 Nov-Dec;24(6):315-320

PMID: 39461716

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