Targeting N-Terminal Pro-Brain Natriuretic Peptide in Older Versus Younger Acute Decompensated Heart Failure Patients
| Autor: | Marco Metra, Paulo Bettencourt, Susan Stienen, Wouter E. Kok, Jan P. Tijssen, Valerio Verdiani, Khibar Salah, Luca Bettari, Antoni Bayes-Genis, Yigal M. Pinto, Luc W. Eurlings, Valentina Lazzarini, Joana Pimenta |
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| Přispěvatelé: | Graduate School, Other departments, Amsterdam Cardiovascular Sciences, Cardiology |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty acute decompensated heart failure Acute decompensated heart failure medicine.drug_class Anemia Adrenergic beta-Antagonists Angiotensin-Converting Enzyme Inhibitors 030204 cardiovascular system & hematology elderly Patient Care Planning Angiotensin Receptor Antagonists 03 medical and health sciences 0302 clinical medicine Cause of Death Internal medicine Natriuretic Peptide Brain medicine Natriuretic peptide Humans 030212 general & internal medicine Mortality Diuretics Intensive care medicine Aged Mineralocorticoid Receptor Antagonists Proportional Hazards Models Cause of death Aged 80 and over Heart Failure NT-proBNP targets Proportional hazards model business.industry young Age Factors Middle Aged medicine.disease Peptide Fragments Heart failure Acute Disease Disease Progression Etiology Population study Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC. Heart failure, 4(9), 736-745. Elsevier BV |
| ISSN: | 2213-1779 |
| Popis: | The aim of this study was to analyze the prognostic value and attainability of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in young and elderly acute decompensated heart failure (ADHF) patients. Less-effective NT-proBNP-guided therapy in chronic heart failure (HF) has been reported in elderly patients. Whether this can be attributed to differences in prognostic value of NT-proBNP or to differences in attaining a prognostic value is unclear. The authors studied this question in ADHF patients. Our study population comprised 7 ADHF cohorts. We defined absolute ( 30%, >50%, and >70%). Six-month all-cause mortality after discharge was studied for each level in Cox regression analyses, and compared between elderly (age >75 years) and young patients (age ≤75 years). Thereafter, we compared percentages of elderly and young patients attaining NT-proBNP levels (= attainability). A total of 1,235 patients (59% male, 45% >75 years of age) was studied. Admission levels of NT-proBNP were significantly higher in elderly versus younger patients. The prognostic value of absolute and relative NT-proBNP levels was similar in elderly and young patients. Attainability was significantly lower in elderly patients for all absolute levels and a >50% relative reduction, but not for >30% and >70%. For absolute levels, attainability differences between age groups were decreased to a large extent after correction for admission NT-proBNP and anemia at discharge. For relative levels, attainability differences disappeared after correction for HF etiology and anemia at discharge. In young and elderly ADHF patients, it is not the prognostic value of absolute and relative NT-proBNP levels that is different, but the attainability of these levels that is lower in the elderly. This can largely be attributed to factors other than age |
| Databáze: | OpenAIRE |
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