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N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients.
Circulation 2004; 110(15):2168-74Circ

Abstract

BACKGROUND

Heart failure (HF) is responsible for a huge burden in hospital care. Our goal was to evaluate the value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) in predicting death or hospital readmission after discharge of HF patients.

METHODS AND RESULTS

We included 182 patients consecutively admitted to hospital because of decompensated HF. Patients were followed up for 6 months. The primary end point was death or readmission. Twenty-six patients died in hospital. The median admission NT-proBNP level was 6778.5 pg/mL, and the median level at discharge was 4137.0 pg/mL (P<0.001). Patients were classified into 3 groups: (1) decreasing NT-proBNP levels by at least 30% (n=82), (2) no significant modifications on NT-proBNP levels (n=49), and (3) increasing NT-proBNP levels by at least 30% (n=25). The primary end point was observed in 42.9% patients. Variables associated with an increased hazard of death and/or hospital readmission in univariate analysis were length of hospitalization, heart rate, signs of volume overload, no use of ACE inhibitors, higher NYHA class at discharge, admission and discharge NT-proBNP, and the change in NT-proBNP levels. The variation in NT-proBNP was the strongest predictor of an adverse outcome. Independent variables associated with an increased risk of readmission or death were signs of volume overload and the change in NT-proBNP levels.

CONCLUSIONS

Variations in NT-proBNP levels are related to hospital readmission and death within 6 months. NT-proBNP levels are potentially useful in the evaluation of treatment efficacy and might help clinicians in planning discharge of HF patients. Whether therapeutic strategies aimed to lower NT-proBNP levels modify prognosis warrants future investigation.

Authors+Show Affiliations

Departamento de Medicina Interna, Serviço de Medicina B-Hospital S. João, Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto, Porto, Portugal. pbettfer@esoterica.pt.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15451800

Citation

Bettencourt, Paulo, et al. "N-terminal-pro-brain Natriuretic Peptide Predicts Outcome After Hospital Discharge in Heart Failure Patients." Circulation, vol. 110, no. 15, 2004, pp. 2168-74.
Bettencourt P, Azevedo A, Pimenta J, et al. N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients. Circulation. 2004;110(15):2168-74.
Bettencourt, P., Azevedo, A., Pimenta, J., Friões, F., Ferreira, S., & Ferreira, A. (2004). N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients. Circulation, 110(15), pp. 2168-74.
Bettencourt P, et al. N-terminal-pro-brain Natriuretic Peptide Predicts Outcome After Hospital Discharge in Heart Failure Patients. Circulation. 2004 Oct 12;110(15):2168-74. PubMed PMID: 15451800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients. AU - Bettencourt,Paulo, AU - Azevedo,Ana, AU - Pimenta,Joana, AU - Friões,Fernando, AU - Ferreira,Susana, AU - Ferreira,António, Y1 - 2004/09/27/ PY - 2004/9/29/pubmed PY - 2005/6/25/medline PY - 2004/9/29/entrez SP - 2168 EP - 74 JF - Circulation JO - Circulation VL - 110 IS - 15 N2 - BACKGROUND: Heart failure (HF) is responsible for a huge burden in hospital care. Our goal was to evaluate the value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) in predicting death or hospital readmission after discharge of HF patients. METHODS AND RESULTS: We included 182 patients consecutively admitted to hospital because of decompensated HF. Patients were followed up for 6 months. The primary end point was death or readmission. Twenty-six patients died in hospital. The median admission NT-proBNP level was 6778.5 pg/mL, and the median level at discharge was 4137.0 pg/mL (P<0.001). Patients were classified into 3 groups: (1) decreasing NT-proBNP levels by at least 30% (n=82), (2) no significant modifications on NT-proBNP levels (n=49), and (3) increasing NT-proBNP levels by at least 30% (n=25). The primary end point was observed in 42.9% patients. Variables associated with an increased hazard of death and/or hospital readmission in univariate analysis were length of hospitalization, heart rate, signs of volume overload, no use of ACE inhibitors, higher NYHA class at discharge, admission and discharge NT-proBNP, and the change in NT-proBNP levels. The variation in NT-proBNP was the strongest predictor of an adverse outcome. Independent variables associated with an increased risk of readmission or death were signs of volume overload and the change in NT-proBNP levels. CONCLUSIONS: Variations in NT-proBNP levels are related to hospital readmission and death within 6 months. NT-proBNP levels are potentially useful in the evaluation of treatment efficacy and might help clinicians in planning discharge of HF patients. Whether therapeutic strategies aimed to lower NT-proBNP levels modify prognosis warrants future investigation. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15451800/N_terminal_pro_brain_natriuretic_peptide_predicts_outcome_after_hospital_discharge_in_heart_failure_patients_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000144310.04433.BE?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -