NT-proBNP in severe chronic heart failure: Rationale, design and preliminary results of the COPERNICUS NT-proBNP substudy

Franz Hartmann, Milton Packer, Andrew J S Coats, Michael B. Fowler, Henry Krum, Paul Mohacsi, Jean L. Rouleau, Michal Tendera, Alain Castaigne, Jürgen Trawinski, Ildiko Amann-Zalan, Silke Hoersch, Hugo A. Katus

Research output: Contribution to journalArticlepeer-review

88 Scopus citations


Background: Neither profiles nor prognostic value of cardiac N-terminal proBNP (NT-proBNP) have been prospectively evaluated in a sufficient number of patients with severe chronic heart failure (CHF) treated with carvedilol or placebo. Methods: Baseline and follow-up plasma concentrations of NT-proBNP were measured in the European part of the COPERNICUS Trial. This study enrolled patients with an ejection fraction <25% and symptoms of CHF at rest or on minimal exertion, equally randomized to placebo or carvedilol. Results: NT-proBNP concentrations were increased at baseline (mean±S.D.= 579±822 pmol/l, median=322.5 pmol/l) with a marked decrease during follow-up in the carvedilol, but not in the placebo group. One-year mortality rates were 3.9, 12 and 27.9% in the lower, middle and upper tertiles of NT-proBNP, respectively. When mortality was calculated separately in the placebo and carvedilol group, rates were 0.8, 6.3 and 19.1% in the carvedilol treated but 6.7, 17.9 and 36.9% in the placebo treated patients. Conclusions: NT-proBNP was a powerful predictor of subsequent all-cause mortality in patients with severe CHF. This marker should therefore be further evaluated for risk stratification and monitoring of therapy in CHF.

Original languageEnglish (US)
Pages (from-to)343-350
Number of pages8
JournalEuropean Journal of Heart Failure
Issue number3
StatePublished - Mar 15 2004


  • Heart failure
  • Natriuretic peptides
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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