Most interestingly, among patients with renal insufficiency, NT-proBNP levels above 1660 ng/l were independently associated with early clinical worsening in a multivariate Cox’s proportional hazards analysis including age, gender, renal function (GFR) as wells as non-invasive prognostic parameter such as 6MWD and WHO FC (Hazard ratio 4.8, 95% CI 1.6–14.9, p = 0.007; Table 2). This evidence concerns the gene NPPB and Renal insufficiency.