@article {izhakianPA3498, author = {shimon izhakian and Assaf Frajman and Lev Freidkin and Mordechai Kramer}, title = {Prognostic significance of amino-terminal pro-brain natriuretic peptide testing among waitlisted lung transplant candidates}, volume = {58}, number = {suppl 65}, elocation-id = {PA3498}, year = {2021}, doi = {10.1183/13993003.congress-2021.PA3498}, publisher = {European Respiratory Society}, abstract = {Background: The prognostic significance of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in lung transplant candidates has not been investigated.Methods: The study was designed as a retrospective single-center investigation. Data regarding various baseline characteristics and all-cause mortality were collected in 172 lung transplant candidates placed in waiting list during November 2017-August 2018. The associations of NT-proBNP levels with baseline characteristics and mortality were analyzed.Results: NT-proBNP values correlated positively with age, forced vital capacity, mean pulmonary artery pressure (MPAP) and pulmonary capillary wedge pressure, while negatively with diffusing lung capacity for carbon monoxide and cardiac index. The optimal cut-off of NT-proBNP for prediction of MPAP levels >=35 mmHg was 251 pg/ml; with 65.2\% sensitivity, 89.3\% specificity, 51.7\% positive predictive value and 93.6\% negative predictive value. On median follow-up period lasting 1.9 years, 81 patients underwent lung transplantation, 31 died waiting for donation, and 60 were alive and still waiting for the transplantation. There was a significantly higher risk of cumulative mortality in waitlisted lung transplant candidates with NT-proBNP level >=450 vs. \<450 pg/ml (hazards ratio [HR] 1.36 and 95\% confidence interval [CI] 0.99-1.86, p=0.05): 1-year (42.8\% vs. 13.9\%), 2-year (47.6\% vs. 20.5\%) and 3-year (47.6\% vs. 25.8\%) mortality rates, respectively. On multivariate analysis, higher NT-proBNP levels remained to be variable strongly associated with increased mortality (HR 1.48, 95\% CI 1.01-2.19, p=0.04).FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3498.This abstract was presented at the 2021 ERS International Congress, in session {\textquotedblleft}Prediction of exacerbations in patients with COPD{\textquotedblright}.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/58/suppl_65/PA3498}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }