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Biomarkers Volume 15, 2010 - Issue 4
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Original Article

New York Heart Association class versus amino-terminal pro-B type natriuretic peptide for acute heart failure prognosis

Aaron L. BaggishCardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USACorrespondence[email protected]
,
Roland R. J. van KimmenadeDepartment of Cardiology, University Hospital Maastricht, Maastricht, the Netherlands
,
Yigal PintoDepartment of Cardiology, University Hospital Maastricht, Maastricht, the Netherlands
,
A. Mark RichardsChristchurch Cardioendocrine Research Group, Christchurch School of Medicine and Health Science, Christchurch, New Zealand
,
John LainchburyChristchurch Cardioendocrine Research Group, Christchurch School of Medicine and Health Science, Christchurch, New Zealand
,
Antoni Bayes-GenisDepartments of Cardiology, Biochemistry and Molecular Biology and Emergency Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain
,
Miquel SantalóDepartments of Cardiology, Biochemistry and Molecular Biology and Emergency Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain
,
Jordi Ordonez-LlanosDepartments of Cardiology, Biochemistry and Molecular Biology and Emergency Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain
&
James L. JanuzziCardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
 show all
Pages 307-314 | Received 29 Nov 2009, Accepted 18 Jan 2010, Published online: 06 Apr 2010
 
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Abstract

Background: The prognostic value of the New York Heart Association classification (NYHAC) in acutely decompensated heart failure (ADHF) is unknown.

Objectives: We sought to determine the relative value of NYHAC among patients with concomitantly measured amino-terminal pro-B type natriuretic peptide (NT-proBNP) at presentation with ADHF.

Materials and methods: NYHAC was determined for 720 patients with ADHF and 1-year mortality status was examined. Cox-proportional hazards analysis compared the prognostic accuracy of NYHAC with other ADHF risk measures.

Results: NYHAC had a significant univariate association with 1-year mortality status (HR 1.41, 95% confidence interval (CI) 1.03–1.94; p = 0.03) but was not a significant predictor of death in a multivariable model that included NT-proBNP (HR 2.14; 95% CI 1.65–2.81, p < 0.001).

Conclusions: In contrast to objective measures such as NT-proBNP, the NYHAC appears to provide limited prognostic information among individuals with ADHF.

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