Predictors of elevated NT-pro-BNP in cardiovascular patients without acute heart failure

AimB-type natriuretic peptides are recommended for evaluation of acute heart failure. Aim of this study was to identify predictors of pathologically elevated NT-pro-BNP in patients without acute heart failure.MethodNT-pro-BNP was measured in 486 inpatients with cardiovascular disease and the association with clinical and laboratory parameters was examined. Elevated NT-pro-BNP was defined according to rule-in cut-off values for acute heart failure: 450 pg/ml for age < 50 years, 900 pg/ml for 50–75 years and 1800 pg/ml for > 75 years.ResultsMultivariate analysis of variables assessable without echocardiography revealed fibrinogen, albumin, atrial fibrillation, history of heart failure and diuretic use as independent predictors of pathological NT-pro-BNP. The odds for pathological NT-pro-BNP were 2.5, 8.8, 27 and 41 in the presence of 1, 2, 3 and 4/5 predictors, respectively. After adjusting for cardiac dysfunction, fibrinogen, albumin, history of heart failure and atrial fibrillation still remained significant.ConclusionAssessment of these parameters could help avoid wrong positive interpretation of NT-pro-BNP results.