Prognostic Value of BNP Reduction During Hospitalization in Patients With Acute Heart Failure
| Autor: | Yasutaka Inuzuka, Takahiro Okumura, Shogo Oishi, Akane Shimizu, Takeshi Kitai, Yu Urakami, Satoshi Suzuki, Masayoshi Yamamoto, Yuya Matsue, Akihiro Hayashida, Misako Toki, Keizo Yamamoto, Keisuke Kida, Nobuyuki Kagiyama, Kozue Matsumoto, Eiichi Akiyama, Shingo Aritaka, Atsushi Mizuno, Tetsuo Yamaguchi, Noriko Nagano |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine Clinical endpoint Natriuretic peptide Medicine In patient cardiovascular diseases 030212 general & internal medicine Ejection fraction business.industry Surrogate endpoint medicine.disease Quartile Heart failure cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business human activities hormones hormone substitutes and hormone antagonists circulatory and respiratory physiology |
| Zdroj: | Journal of Cardiac Failure. 25:712-721 |
| ISSN: | 1071-9164 |
| DOI: | 10.1016/j.cardfail.2019.04.004 |
| Popis: | Background Prognostication of patients discharged after acute heart failure (AHF) hospitalization remains challenging. Body weight (BW) reduction is often used as a surrogate marker of decongestion despite the paucity of evidence. We thought to test the hypothesis that B-type natriuretic peptide (BNP) reduction during hospitalization has independent prognostic value in AHF. Methods and Results We studied the prognostic predictability of percentage BNP reduction achieved during hospitalization in patients from the REALITY-AHF study. Percentage BNP reduction was defined as (BNP on admission − BNP at discharge) / BNP on admission × 100. The primary endpoint was 1-year all-cause death. In 1028 patients (age, 77 ± 13 years; 57% male; left ventricular ejection fraction, 47 ± 16%) with AHF, median BNP level at admission was 747 ng/L (interquartile range, 439–1367 ng/L) and median percentage BNP reduction was 62.5% (interquartile range, 36.5–78.5%). The smallest percentage BNP reduction quartile had more than 2-fold higher risk of all-cause death than the greatest quartile (23.0% vs 9.7%, P Conclusions The prognostic value of percentage BNP reduction during hospitalization was superior to that of percentage BW reduction and was independent of other risk markers, including BNP at discharge. |
| Databáze: | OpenAIRE |
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