Brain Natriuretic Peptide as the long-term cause of mortality in patients with cardiovascular disease: a retrospective cohort study.

Objective: To explore the influence of BNP (Brain Natriuretic Peptide) in plasma on the long-term cause of mortality and prognosis of patients with cardiovascular disease (CVD).

Method: We performed a retrospective cohort study of 276 inpatients that enrolled in our hospital from March 2003 to December 2004 and had a history of heart disease and received a BNP test. Kaplan-Meier survival curves with Log-Rank test were used to compare the survival rates among different levels of BNP (<100 ng/L, 101~1000 ng/L, 1001~5000 ng/L and >5000 ng/L). Cox proportional hazards regression models were used to estimate HRs and 95% CIs with adjustments for other covariance's.

Result: After a median follow-up of 7 years, a total of 91 patients died of whom fifty were cardiogenic deaths and 41 were non-cardiogenic. The survival rates were of statistical significance (P=0.0000) between the different levels of BNP in the 4 groups, and the mortality rate increased gradually with the increase in BNP concentration. Multivariable Cox regression analysis showed that BNP levels were inversely associated with the survival rate in CVD patients (HR=0.24, 95% CI: 0.13~0.42). In addition, age and left ventricular ejection fraction values were also of statistical significance in the Cox regression model.

Conclusion: Our findings suggested that high Plasma BNP levels may have an adverse effect on the prognosis of patients with cardiovascular disease.