064: Interest of BNP in very old patients: the BNP Elderly Dyspnea (BED) Study

BackgroundFew data are available on the value of BNP in older-old subjects. The aim of this study was to evaluate the benefit of BNP for heart failure diagnosis in very old patients.MethodsThe BED is a French multicenter observational prospective study that enrolled 383 very old subjects (≥80 yo) hospitalized in geriatric care with acute dyspnea. BNP was measured in acute phase, before any diuretic treatment. Cardiologists categorized the subjects into 3 subgroups according to ESC criteria and blinded to BNP level: heart failure (HF), respiratory failure and mixed disease (HF and respiratory failure combined). Subjects with mixed disease were then reclassified into HF or respiratory failure groups according to the predominant feature (cardiac or respiratory). We analyzed the prognostic value (sensibility, sensitivity and area under curve (AUC)) of the BNP for the diagnosis of HF, mixed disease included and excluded.ResultsMean age was 89±5 years, 66% of the patients were women, 57% had previous history of HF, 67% hypertension, 13% diabetes, 33% coronary heart disease and 49% atrial fibrillation. Mean LVEF was 56±13%. Several patients had non-cardiac comorbidities, malnutrition 48%, severe renal failure 41%, dementia 38%, depression 32%, COPD 17%, and cancer 12%. Fifty percent of the subjects had cardiac dyspnea, 26% respiratory dyspnea and 24% dyspnea of mixed origin. Mean BNP values were 675 (835), 301 (366), 558 (796)pg/mL (p