The combination of B-type natriuretic peptide and C-reactive protein provides incremental prognostic value among older patients referred for cardiac Catheterization

Recent clinical studies have demonstrated the utility of B-type natriuretic peptide (BNP) and C-reactive protein (CRP) for predicting cardiovascular outcomes. The authors hypothesized that a combined biomarker score would provide incremental prognostic value among older individuals. Clinical data, biomarkers, and echocardiograms were obtained in 200 geriatric patients referred for cardiac catheterization. Tertile score was defined as the sum of an individual's BNP tertile plus CRP tertile within the study population, for a total score from 2 to 6. The primary end point was cardiovascular hospitalization or death at 6 months. Univariate predictors of events included prior heart failure, atrial fibrillation, left ventricular systolic dysfunction, functional class, significant mitral regurgitation, BNP, CRP, and the tertile score. In contrast to BNP or CRP alone, the tertile score consistently provided incremental value when added to clinical predictors in multivariate models. A simple summation score may help clinicians predict outcomes in symptomatic geriatric patients beyond standard clinical variables.