Exploring the relation between changes in NT-proBNP and renal function in patients with suspected heart failure using structural equation modelling

Zhang, J., Wong, K. Y.-K., Clark, A. L. and Cleland, J. G.F. (2017) Exploring the relation between changes in NT-proBNP and renal function in patients with suspected heart failure using structural equation modelling. International Journal of Cardiology, 233, pp. 67-72. (doi: 10.1016/j.ijcard.2017.01.127) (PMID:28169056)

Abstract

Background: The relation between changes in NT-proBNP and renal function has commonly been studied using multiple regressions, which may ignore the complexity of relations between related variables. Methods and results: Data were collected from patients referred with suspected heart failure (HF) to a community service. Structural equation modelling (SEM) was used to assess the association between changes in NT-proBNP at 1 year, and other pre-specified variables including age, sex, BMI, eGFR, loop diuretics and ACE inhibitor. Of 1006 patients with a follow-up NT-proBNP at 1 year, 882 (88%) had HF. The baseline median age was 72 (IQR: 63–78) years, 732 (73%) were men, 668 (66%) had left ventricular systolic dysfunction and 769 (76%) had NT-proBNP > 400 pg/ml. For all patients at 1 year, 243 (24%) patients had at least a 50% reduction in NT-proBNP, and 199 (20%) had at least a 50% increase, only 40 (3%) had < 3% change. Change in NT-proBNP was strongly associated with baseline NT-proBNP (the standardized coefficient (r) = 0.73, p < 0.001). The change in NT-proBNP was not associated with changes in eGFR, and was indirectly related with age, BMI, eGFR and loop diuretics (p < 0.01 for all). Conclusions: Baseline NT-proBNP was the main determinant of change in NT-proBNP at one year.

• Item Type: Articles
• Additional Information: Prof Cleland is supported, in part, by the NIHR Cardiovascular Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London and is an NIHR Senior Investigator.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Zhang, J., Wong, K. Y.-K., Clark, A. L., and Cleland, J. G.F.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: International Journal of Cardiology
• Publisher: Elsevier
• ISSN: 0167-5273
• ISSN (Online): 1874-1754
• Published Online: 27 January 2017
• Copyright Holders: Copyright © 2017 Elsevier Ireland Ltd.
• First Published: First published in International Journal of Cardiology 233: 67-72
• Publisher Policy: Reproduced in accordance with the publisher copyright policy