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NT-ProBNP reduction percentage during admission for acutely decompensated heart failure predicts long-term cardiovascular mortality.
J Card Fail 2005; 11(5 Suppl):S3-8JC

Abstract

BACKGROUND

N-terminal brain natriuretic peptide (NT-proBNP) improves emergency room diagnosis of acutely decompensated heart failure. Less evidence is available on the usefulness of NT-proBNP as a prognostic marker after hospitalization for acute heart failure. The percentage of NT-proBNP reduction during admission and its prognostic significance were studied.

METHODS AND RESULTS

This was a prospective study of 74 patients in the emergency department who were diagnosed with acute heart failure and who had follow-up evaluation for 6 and 12 months after admission. Plasma NT-proBNP concentrations were measured on admission, at 24 hours, at day 7, and at 6 and 12 months. Eighteen patients died during the 12-month follow-up; 12 deaths were from cardiovascular causes. NT-proBNP concentrations were significantly higher in the emergency department and at 24 hours than those concentrations that were found at day 7 and beyond (P < .001). During admission, the NT-proBNP concentration fell a mean of 15% in patients who died of cardiovascular causes during the 1-year follow-up evaluation, in 75% in those patients who died of non-cardiovascular causes, and in 50% in survivors (P = .004). The area under the receiver operator characteristic curve for NT-proBNP reduction percentage to predict cardiovascular death was 0.78 (95% CI, 0.66-0.90; P = .002). A 30% NT-proBNP reduction percentage cutoff value had 75% accuracy for the identification of high-risk patients and was the only variable that was associated with cardiovascular death in multivariate analysis (odds ratio, 4.4; 95% CI, 1.12-17.4; P = .03).

CONCLUSION

NT-proBNP reduction percentage during admission for acutely decompensated heart failure appeared to be the best predictor of cardiovascular death during the follow-up period. A <30% NT-proBNP reduction percentage identified a subgroup of high-risk patients.

Authors+Show Affiliations

Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15948093

Citation

Bayés-Genís, Antoni, et al. "NT-ProBNP Reduction Percentage During Admission for Acutely Decompensated Heart Failure Predicts Long-term Cardiovascular Mortality." Journal of Cardiac Failure, vol. 11, no. 5 Suppl, 2005, pp. S3-8.
Bayés-Genís A, Lopez L, Zapico E, et al. NT-ProBNP reduction percentage during admission for acutely decompensated heart failure predicts long-term cardiovascular mortality. J Card Fail. 2005;11(5 Suppl):S3-8.
Bayés-Genís, A., Lopez, L., Zapico, E., Cotes, C., Santaló, M., Ordonez-Llanos, J., & Cinca, J. (2005). NT-ProBNP reduction percentage during admission for acutely decompensated heart failure predicts long-term cardiovascular mortality. Journal of Cardiac Failure, 11(5 Suppl), pp. S3-8.
Bayés-Genís A, et al. NT-ProBNP Reduction Percentage During Admission for Acutely Decompensated Heart Failure Predicts Long-term Cardiovascular Mortality. J Card Fail. 2005;11(5 Suppl):S3-8. PubMed PMID: 15948093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - NT-ProBNP reduction percentage during admission for acutely decompensated heart failure predicts long-term cardiovascular mortality. AU - Bayés-Genís,Antoni, AU - Lopez,Laura, AU - Zapico,Edgar, AU - Cotes,Carlos, AU - Santaló,Miquel, AU - Ordonez-Llanos,Jordi, AU - Cinca,Juan, PY - 2005/6/11/pubmed PY - 2006/3/10/medline PY - 2005/6/11/entrez SP - S3 EP - 8 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 11 IS - 5 Suppl N2 - BACKGROUND: N-terminal brain natriuretic peptide (NT-proBNP) improves emergency room diagnosis of acutely decompensated heart failure. Less evidence is available on the usefulness of NT-proBNP as a prognostic marker after hospitalization for acute heart failure. The percentage of NT-proBNP reduction during admission and its prognostic significance were studied. METHODS AND RESULTS: This was a prospective study of 74 patients in the emergency department who were diagnosed with acute heart failure and who had follow-up evaluation for 6 and 12 months after admission. Plasma NT-proBNP concentrations were measured on admission, at 24 hours, at day 7, and at 6 and 12 months. Eighteen patients died during the 12-month follow-up; 12 deaths were from cardiovascular causes. NT-proBNP concentrations were significantly higher in the emergency department and at 24 hours than those concentrations that were found at day 7 and beyond (P < .001). During admission, the NT-proBNP concentration fell a mean of 15% in patients who died of cardiovascular causes during the 1-year follow-up evaluation, in 75% in those patients who died of non-cardiovascular causes, and in 50% in survivors (P = .004). The area under the receiver operator characteristic curve for NT-proBNP reduction percentage to predict cardiovascular death was 0.78 (95% CI, 0.66-0.90; P = .002). A 30% NT-proBNP reduction percentage cutoff value had 75% accuracy for the identification of high-risk patients and was the only variable that was associated with cardiovascular death in multivariate analysis (odds ratio, 4.4; 95% CI, 1.12-17.4; P = .03). CONCLUSION: NT-proBNP reduction percentage during admission for acutely decompensated heart failure appeared to be the best predictor of cardiovascular death during the follow-up period. A <30% NT-proBNP reduction percentage identified a subgroup of high-risk patients. SN - 1071-9164 UR - https://www.unboundmedicine.com/medline/citation/15948093/NT_ProBNP_reduction_percentage_during_admission_for_acutely_decompensated_heart_failure_predicts_long_term_cardiovascular_mortality_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071916405001715 DB - PRIME DP - Unbound Medicine ER -