Supplementary Material for: Visit-to-Visit B-Type Natriuretic Peptide Variability during the Previous Year Has Independent Prognostic Value in Patients with Stable Chronic Heart Failure Kagiyama N. Yuri T. Hayashida A. Hirohata A. Yamamoto K. Yoshida K. 10.6084/m9.figshare.8977004.v1 https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Visit-to-Visit_B-Type_Natriuretic_Peptide_Variability_during_the_Previous_Year_Has_Independent_Prognostic_Value_in_Patients_with_Stable_Chronic_Heart_Failure/8977004 <b><i>Background:</i></b> There is wide variability of visit-to-visit (V2V) B-type natriuretic peptide (BNP) in patients with chronic heart failure (CHF), even when they are stable. The prognostic significance of V2V-BNP variability has not been investigated. We aimed to test whether V2V-BNP variability during the stable period of CHF has prognostic value regardless of BNP level. <b><i>Methods:</i></b> In 278 stable outpatients (75 ± 10 years, 65% male) with CHF, we studied V2V-BNP variability, which was defined as the coefficient of variance of BNP values measured during 1 year before enrollment. All-cause death and rehospitalization due to HF were considered the primary endpoint. <b><i>Results:</i></b> The median V2V-BNP variability was 25.7% (IQR: 19.2–34.4%). During the follow-up period (median 3.2 years), 100 patients reached the endpoint and those with high V2V-BNP variability (≥25.7%) had a significantly higher rate of events (<i>p</i> = 0.001). CHF severity in terms of BNP level and MAGGIC risk score was not significantly different between those with high and low V2V-BNP variability. Multivariable analysis showed that high V2V-BNP variability was independently associated with increased event rates even after adjustment for other known prognostic predictors, including BNP (hazard ratio 1.90, <i>p</i> = 0.003), or for MAGGIC risk score and BNP (hazard ratio 1.72, <i>p</i> = 0.010). The hazard for the outcome consistently increased as V2V-BNP variability increased, with a marked increase up to about 30%. <b><i>Conclusions:</i></b> Even in the stable phase of CHF, V2V-BNP variability was associated with worse long-term outcomes, independent of BNP level. 2019-07-22 13:46:35 Heart failure Biomarker B-type natriuretic peptide Visit-to-visit variability