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Baseline and 6-month B-type natriuretic peptide changes are independent predictors of events in patients with advanced heart failure awaiting cardiac transplantation.
J Cardiovasc Med (Hagerstown) 2009; 10(9):671-6JC

Abstract

OBJECTIVE

To assess the prognostic role of B-type natriuretic peptide (BNP) measured at baseline and after 6 months in advanced heart failure patients, candidates for heart transplantation.

METHODS

Ninety-nine patients with BNP evaluation (mean age 50.8 years, 85% men) were admitted in the heart transplantation waiting list; 39% were in New York Heart Association functional class IV; with hemodynamic patterns of severe heart failure, the cause was ischemic in 45% and idiopathic in 44%. In order to identify more severe patients, BNP values and changes at 6 months were dichotomized according to their upper tertile (>1100 and >or=70 pg/ml, respectively).

RESULTS

Median baseline BNP was 719 pg/ml. After a median of 45 months, 40 events were observed (three cardiac assist device implants, 16 urgent heart transplantations, 13 sudden deaths and eight deaths from heart failure). The event rate was 10.0 and 32.3 per 100 person-years in patients with low and high BNP, respectively. In a bivariable Cox regression, BNP at entry in the list and change in BNP at 6 months were independent predictors of events, with hazard ratios of 4.10 (95% confidence interval 2.14-7.88, P<0.001) and 4.55 (95% confidence interval 2.36-8.80, P<0.001), respectively. Furthermore, the risk increased from neither BNP/BNP change, to one of them and to both of them present.

CONCLUSION

Both high baseline and further increase in BNP levels during midterm follow-up are strong predictors of events in patients with advanced heart failure awaiting heart transplantation.

Authors+Show Affiliations

Department of Cardiology, Clinical Epidemiology and Biometry Service, Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. unita.sc@smatteo.pv.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19444135

Citation

Campana, Carlo, et al. "Baseline and 6-month B-type Natriuretic Peptide Changes Are Independent Predictors of Events in Patients With Advanced Heart Failure Awaiting Cardiac Transplantation." Journal of Cardiovascular Medicine (Hagerstown, Md.), vol. 10, no. 9, 2009, pp. 671-6.
Campana C, Pasotti M, Klersy C, et al. Baseline and 6-month B-type natriuretic peptide changes are independent predictors of events in patients with advanced heart failure awaiting cardiac transplantation. J Cardiovasc Med (Hagerstown). 2009;10(9):671-6.
Campana, C., Pasotti, M., Klersy, C., Alessandrino, G., Albertini, R., Magrini, G., ... Tavazzi, L. (2009). Baseline and 6-month B-type natriuretic peptide changes are independent predictors of events in patients with advanced heart failure awaiting cardiac transplantation. Journal of Cardiovascular Medicine (Hagerstown, Md.), 10(9), pp. 671-6. doi:10.2459/JCM.0b013e328329346a.
Campana C, et al. Baseline and 6-month B-type Natriuretic Peptide Changes Are Independent Predictors of Events in Patients With Advanced Heart Failure Awaiting Cardiac Transplantation. J Cardiovasc Med (Hagerstown). 2009;10(9):671-6. PubMed PMID: 19444135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Baseline and 6-month B-type natriuretic peptide changes are independent predictors of events in patients with advanced heart failure awaiting cardiac transplantation. AU - Campana,Carlo, AU - Pasotti,Michele, AU - Klersy,Catherine, AU - Alessandrino,Giuseppe, AU - Albertini,Riccardo, AU - Magrini,Giulia, AU - Ghio,Stefano, AU - Tavazzi,Luigi, PY - 2009/5/16/entrez PY - 2009/5/16/pubmed PY - 2009/9/9/medline SP - 671 EP - 6 JF - Journal of cardiovascular medicine (Hagerstown, Md.) JO - J Cardiovasc Med (Hagerstown) VL - 10 IS - 9 N2 - OBJECTIVE: To assess the prognostic role of B-type natriuretic peptide (BNP) measured at baseline and after 6 months in advanced heart failure patients, candidates for heart transplantation. METHODS: Ninety-nine patients with BNP evaluation (mean age 50.8 years, 85% men) were admitted in the heart transplantation waiting list; 39% were in New York Heart Association functional class IV; with hemodynamic patterns of severe heart failure, the cause was ischemic in 45% and idiopathic in 44%. In order to identify more severe patients, BNP values and changes at 6 months were dichotomized according to their upper tertile (>1100 and >or=70 pg/ml, respectively). RESULTS: Median baseline BNP was 719 pg/ml. After a median of 45 months, 40 events were observed (three cardiac assist device implants, 16 urgent heart transplantations, 13 sudden deaths and eight deaths from heart failure). The event rate was 10.0 and 32.3 per 100 person-years in patients with low and high BNP, respectively. In a bivariable Cox regression, BNP at entry in the list and change in BNP at 6 months were independent predictors of events, with hazard ratios of 4.10 (95% confidence interval 2.14-7.88, P<0.001) and 4.55 (95% confidence interval 2.36-8.80, P<0.001), respectively. Furthermore, the risk increased from neither BNP/BNP change, to one of them and to both of them present. CONCLUSION: Both high baseline and further increase in BNP levels during midterm follow-up are strong predictors of events in patients with advanced heart failure awaiting heart transplantation. SN - 1558-2027 UR - https://www.unboundmedicine.com/medline/citation/19444135/Baseline_and_6_month_B_type_natriuretic_peptide_changes_are_independent_predictors_of_events_in_patients_with_advanced_heart_failure_awaiting_cardiac_transplantation_ L2 - http://Insights.ovid.com/pubmed?pmid=19444135 DB - PRIME DP - Unbound Medicine ER -