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Comparison of the prognostic usefulness of N-terminal pro-brain natriuretic Peptide in patients with heart failure with versus without chronic kidney disease.
Am J Cardiol. 2008 Aug 15; 102(4):469-74.AJ

Abstract

In patients with chronic heart failure (CHF), N-terminal pro-brain natriuretic peptide (NT-pro-BNP) predicted poor outcome. Clinical predictors of NT-pro-BNP and its usefulness in the presence of chronic kidney disease (CKD) are largely unknown. A total of 341 patients with stable CHF were enrolled, of whom 183 (54%) had CKD. During a follow-up of 620 +/- 353 days, 57 patients (17%) experienced a cardiac event (cardiac death, need for extracorporeal assist device, or urgent cardiac transplantation), and 64 patients (20%) were rehospitalized because of worsening CHF. NT-pro-BNP was related to New York Heart Association functional class (R = 0.44, p <0.001) and inversely related to ejection fraction (R = -0.52, p <0.001) and glomerular filtration rate (R = -0.32, p <0.001). A cardiac event was independently predicted by NT-pro-BNP (hazard ratio [HR] 1.56, p <0.001), ejection fraction (HR 0.95, p = 0.018), and serum sodium (HR 0.89, p = 0.004). Using receiver-operator characteristic analysis, NT-pro-BNP > or =1,474 pg/ml best separated patients with or without cardiac events. In patients without CKD, outcome was significantly worse in patients with NT-pro-BNP >1,474 pg/ml in comparison to patients with NT-pro-BNP <1,474 pg/ml (event-free survival rate 0% vs 75%; p <0.001). In patients with CKD, outcome was also significantly worse in subjects with NT-pro-BNP >1,474 pg/ml in comparison to those with NT-pro-BNP <1,474 pg/ml (event-free survival rate 48% vs 93%; p <0.001). NT-pro-BNP independently predicted rehospitalization caused by worsening CHF (HR 1.26, p = 0.023), and a cut-off value of 1,474 pg/ml also separated patients with poor and intermediate prognosis in the CKD and non-CKD groups. In conclusion, NT-pro-BNP independently predicted morbidity and mortality in patients with CHF with and without CKD.

Authors+Show Affiliations

Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18678308

Citation

Bruch, Christian, et al. "Comparison of the Prognostic Usefulness of N-terminal Pro-brain Natriuretic Peptide in Patients With Heart Failure With Versus Without Chronic Kidney Disease." The American Journal of Cardiology, vol. 102, no. 4, 2008, pp. 469-74.
Bruch C, Fischer C, Sindermann J, et al. Comparison of the prognostic usefulness of N-terminal pro-brain natriuretic Peptide in patients with heart failure with versus without chronic kidney disease. Am J Cardiol. 2008;102(4):469-74.
Bruch, C., Fischer, C., Sindermann, J., Stypmann, J., Breithardt, G., & Gradaus, R. (2008). Comparison of the prognostic usefulness of N-terminal pro-brain natriuretic Peptide in patients with heart failure with versus without chronic kidney disease. The American Journal of Cardiology, 102(4), 469-74. https://doi.org/10.1016/j.amjcard.2008.03.082
Bruch C, et al. Comparison of the Prognostic Usefulness of N-terminal Pro-brain Natriuretic Peptide in Patients With Heart Failure With Versus Without Chronic Kidney Disease. Am J Cardiol. 2008 Aug 15;102(4):469-74. PubMed PMID: 18678308.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the prognostic usefulness of N-terminal pro-brain natriuretic Peptide in patients with heart failure with versus without chronic kidney disease. AU - Bruch,Christian, AU - Fischer,Claudia, AU - Sindermann,Jürgen, AU - Stypmann,Jörg, AU - Breithardt,Günter, AU - Gradaus,Rainer, Y1 - 2008/05/24/ PY - 2008/01/28/received PY - 2008/03/24/revised PY - 2008/03/24/accepted PY - 2008/8/6/pubmed PY - 2008/9/20/medline PY - 2008/8/6/entrez SP - 469 EP - 74 JF - The American journal of cardiology JO - Am J Cardiol VL - 102 IS - 4 N2 - In patients with chronic heart failure (CHF), N-terminal pro-brain natriuretic peptide (NT-pro-BNP) predicted poor outcome. Clinical predictors of NT-pro-BNP and its usefulness in the presence of chronic kidney disease (CKD) are largely unknown. A total of 341 patients with stable CHF were enrolled, of whom 183 (54%) had CKD. During a follow-up of 620 +/- 353 days, 57 patients (17%) experienced a cardiac event (cardiac death, need for extracorporeal assist device, or urgent cardiac transplantation), and 64 patients (20%) were rehospitalized because of worsening CHF. NT-pro-BNP was related to New York Heart Association functional class (R = 0.44, p <0.001) and inversely related to ejection fraction (R = -0.52, p <0.001) and glomerular filtration rate (R = -0.32, p <0.001). A cardiac event was independently predicted by NT-pro-BNP (hazard ratio [HR] 1.56, p <0.001), ejection fraction (HR 0.95, p = 0.018), and serum sodium (HR 0.89, p = 0.004). Using receiver-operator characteristic analysis, NT-pro-BNP > or =1,474 pg/ml best separated patients with or without cardiac events. In patients without CKD, outcome was significantly worse in patients with NT-pro-BNP >1,474 pg/ml in comparison to patients with NT-pro-BNP <1,474 pg/ml (event-free survival rate 0% vs 75%; p <0.001). In patients with CKD, outcome was also significantly worse in subjects with NT-pro-BNP >1,474 pg/ml in comparison to those with NT-pro-BNP <1,474 pg/ml (event-free survival rate 48% vs 93%; p <0.001). NT-pro-BNP independently predicted rehospitalization caused by worsening CHF (HR 1.26, p = 0.023), and a cut-off value of 1,474 pg/ml also separated patients with poor and intermediate prognosis in the CKD and non-CKD groups. In conclusion, NT-pro-BNP independently predicted morbidity and mortality in patients with CHF with and without CKD. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/18678308/Comparison_of_the_prognostic_usefulness_of_N_terminal_pro_brain_natriuretic_Peptide_in_patients_with_heart_failure_with_versus_without_chronic_kidney_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(08)00675-9 DB - PRIME DP - Unbound Medicine ER -