Combining the use of amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide in the prognosis of hospitalized heart failure patients
| Autor: | Pengchao Tian, Jian Zhang, Rongcheng Zhang, Yunhong Wang, Qiong Zhou, Yan Huang, Yuhui Huang, Tao An, Xuemei Zhao, Mei Zhai, Yuhui Zhang |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty medicine.drug_class medicine.medical_treatment Clinical Biochemistry Biochemistry 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine Natriuretic Peptide Brain medicine Clinical endpoint Natriuretic peptide Humans cardiovascular diseases Retrospective Studies Heart transplantation Heart Failure Proportional hazards model Biochemistry (medical) Hazard ratio General Medicine Middle Aged medicine.disease Prognosis Peptide Fragments Hospitalization 030104 developmental biology Quartile ROC Curve 030220 oncology & carcinogenesis Heart failure Cardiology Female hormones hormone substitutes and hormone antagonists |
| Zdroj: | Clinica chimica acta; international journal of clinical chemistry. 491 |
| ISSN: | 1873-3492 |
| Popis: | To investigate whether the combination of measuring amino-terminal pro-B-type natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) could provide additional prognostic value in hospitalized heart failure patients.We measured both BNP and NT-proBNP simultaneously at baseline in 1464 hospitalized heart failure patients who were admitted to our heart failure center. All patients were followed-up with the median follow-up period of 533 days. The primary endpoint is a composite of all-cause death (non-transplantation patients) or heart transplantation.The median molar ratio of NT-proBNP/BNP was 2.37, but the range of the molar ratio varied from 1.57 to 3.75 (lower quartile to higher quartile). Using the cut-off value of 1790 pg/mL for NT-proBNP and 495 pg/mL for BNP from the ROC curve analysis, univariate Cox proportional regression analysis showed that the low/high group (NT-proBNP1790 pg/mL and BNP ≥ 495 pg/mL), high/low group (NT-proBNP ≥ 1790 pg/mL and BNP495 pg/mL) and high/high group (NT-proBNP ≥ 1790 pg/mL and BNP ≥ 495 pg/mL) had significant higher risk of all-cause death or heart transplantation [HR (hazard ratio): 2.87, 95% CI (confidence interval): 1.69-4.89, p .001; HR: 2.68, 95% CI: 1.91-3.76, p .001; HR:5.07, 95% CI: 3.85-6.67, p .001] than low/low group (NT-proBNP1790 pg/mL and BNP495 pg/mL). In turn, the high/high group had higher risk of all-cause death or heart transplantation than low/high (HR: 1.70, 95% CI: 1.04-2.80, p = .035) and high/low groups (HR: 1.88, 95% CI: 1.42-2.49, p .001). The low/high and high/low groups had a similar risk of all-cause death or heart transplantation. Further multivariable Cox regression analysis also showed that both BNP and NT-proBNP above the cut-off values independently predicted the worst prognosis, while either one of the two biomarkers above the cut-off value indicated the moderate poor prognosis and both below the cut-off values indicated the best prognosis (p for trend0.001).The plasma levels of NT-proBNP and BNP do not always increase proportionally in heart failure patients. The combination of testing NT-proBNP and BNP may add prognostic value to predict adverse events in hospitalized heart failure patients. |
| Databáze: | OpenAIRE |
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