| Comparison of usefulness of each of five predictors of mortality and urgent transplantation in patients with advanced heart failure. | |
| | |
MedLine Citation:
|
PMID: 20816124 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
B-type natriuretic peptide (BNP), peak oxygen consumption (VO(2)), blood urea nitrogen (BUN), systolic blood pressure (SBP), and pulmonary capillary wedge pressure are all established predictors of mortality or urgent transplantation in patients with advanced heart failure (HF). However, their comparative predictive ability in estimating prognosis has not been well studied. We analyzed 1,215 patients with advanced systolic HF referred to a university center from 1999 to 2009. BUN, BNP, VO(2), SBP, and pulmonary capillary wedge pressure were measured as a part of the initial evaluation. The patients were divided into groups according to the best cutoffs for predicting both 1- and 2-year mortality from the analysis of the receiver operating characteristic curves (BNP > or =579 pg/ml, peak VO(2) <14 ml/kg/min, BUN > or =53 mg/dl, SBP <118 mm Hg, and pulmonary capillary wedge pressure > or =21 mm Hg). During a 2-year follow-up, 234 patients (19%) died, and 208 (17%) required urgent transplantation. BNP (odds ratio 4.3, 95% confidence interval 3.3 to 5.5) and peak VO(2) (odds ratio 4.5, 95% confidence interval 2.6 to 7.8) were the strongest predictors for death or urgent transplantation. On multivariate analyses, BNP and peak VO(2) were the strongest predictors for both death or urgent transplantation and all-cause mortality. The c-statistic was 0.756 for BNP, 0.701 for VO(2), 0.659 for BUN, 0.638 for SBP, and 0.650 for pulmonary capillary wedge pressure. In conclusion, of the 5 established predictors of outcomes in advanced HF, BNP was the most robust discriminator of risk and thus could be useful, along with other more traditional prognostic variables, in patient counseling regarding prognosis and determining the timing for heart transplantation. |
| | |
Authors:
|
Amit Sachdeva; Tamara B Horwich; Gregg C Fonarow |
Related Documents
:
|
2363894 - Spontaneous changes of systolic blood pressure as predictors of future fatal events. it... 11913604 - The association between racial identity and hypertension in african-american adults: el... 17496464 - Comparison of noninvasive oscillometric and intra-arterial blood pressure measurements ... 9585914 - Psychophysiologic sensitization to headlight glare among professional drivers with and ... 12453964 - Usefulness of home blood pressure measurement in the morning in type 2 diabetic patients. 1322284 - The role of the adrenal gland in hypertensive transgenic rat tgr(mren2)27. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-01 |
Journal Detail:
|
Title: The American journal of cardiology Volume: 106 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Sep |
Date Detail:
|
Created Date: 2010-09-06 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 830-5 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Medicine, University of California, Los Angeles, Medical Center, Los Angeles, California, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Biological Markers / blood Blood Pressure* Blood Urea Nitrogen Female Heart Failure / blood, mortality, physiopathology, surgery* Heart Transplantation* / mortality Humans Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain / blood* Oxygen Consumption* Predictive Value of Tests Prognosis Pulmonary Wedge Pressure* Retrospective Studies Risk Assessment Risk Factors Severity of Illness Index Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Effectiveness of lowering blood pressure to prevent stroke versus to prevent coronary events.
Next Document: Serial changes in left ventricular shape following early mitral valve repair.