• Heikki O Koskela, Päivi H Salonen, Jarkko Romppanen, and Juha Hartikainen.
• School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
• ESC Heart Fail. 2015 Jun 1; 2 (2): 69-75.

AimsPneumonia and acute exacerbations of obstructive lung diseases (AEOLD) are associated with a significant long-term mortality. Elevated level of amino-terminal pro B-type natriuretic peptide (NT-proBNP) is a predictor of late all-cause mortality in these disorders but the pathophysiological basis for this is unknown. The present study was conducted to define the predictive role of NT-proBNP on late cardiovascular mortality among patients with acute lung disorders.Methods And ResultsThis prospective, observational cohort study included 269 hospitalized patients with pneumonia or AEOLD. Plasma level of NT-proBNP, age, sex, body mass index, arterial blood oxygen saturation, C-reactive protein, and urea were recorded. The survival and causes of death were recorded after a median of six years. NT-proBNP > 666 ng/mL was related to cardiovascular mortality with an adjusted hazard ratio of 2.93 (1.19-7.18). This risk was of similar magnitude to that associated with diabetes and greater than that associated with arterial hypertension, hypercholesterolemia, and smoking. NT-proBNP was also related to all-cause mortality with adjusted hazard ratio of 2.39 (1.49-3.85) per 10 times increase in NT-proBNP concentration. However, the association between NT-proBNP and non-cardiovascular mortality did not reach statistical significance [adjusted hazard ratio 1.89 (0.93-3.85)].ConclusionNT-proBNP concentration during pneumonia or AEOLD was strongly associated with late cardiovascular mortality but not with non-cardiovascular mortality. The results suggest that the increase in NT-proBNP during acute lung disorders may reveal occult cardiac diseases arousing a question whether patients with acute pulmonary disorders with elevated NT-proBNP levels should be subjected to further diagnostic or therapeutic cardiovascular interventions.© 2015 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

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