Document Detail

Prognostic utility of NT-proBNP in acute exacerbations of chronic pulmonary diseases.
MedLine Citation:
PMID:  21402247     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: The prognostic value of NT-proBNP levels in patients admitted to hospital due to acute exacerbations of chronic pulmonary diseases (CPDs) is unknown.
SETTING: Internal Medicine units at two general hospitals.
METHODS: NT-proBNP levels were obtained within 72h after admission in 192 consecutive patients with acute exacerbations of CPDs and no history of heart failure or diuretic treatment. Clinical characteristics and main outcomes were assessed over a 12-month follow-up. NT-proBNP cut-points for outcomes were obtained by ROC (receiver operating characteristics) curve analysis.
RESULTS: Chronic obstructive lung disease (69.3%) and chronic asthma (22.4%) were the most prevalent CPDs, and non-pneumonic acute respiratory infection (72.4%) and pneumonia (22.9%) were the most frequent causes of exacerbation. Atrial flutter or fibrillation rate was 11%. During the one-year follow-up period, 22 patients died, 42 were re-admitted, 46 received new long-term oxygen therapy, and 39 received new diuretic treatment. NT-proBNP values correlated with hospitalisation days. NT-proBNP values over 587.9pg/ml were associated with significantly raised one-year mortality (OR=3.90; 95% IC 1.46-10.47; p=0.006) and over 782.2pg/ml with cardio-pulmonary deaths (OR=6.38; 95% IC 1.91-21.3; p=0.002). That association persisted after adjustment for age, gender, creatinine levels and cardiac rhythm. NT-proBNP values over 628.7pg/ml were associated with significantly higher probability of new diuretic treatment (OR=4.38; IC 95% 2.07-9.25; p<0.001). The negative predictive values for these cut-points ranged from 89% to 97%.
CONCLUSION: NT-proBNP levels below 587.9pg/ml in patients with acute exacerbations of CPD were associated with favourable one-year outcomes.
Araceli Molina Medina; Marta Sanchez Marteles; Elisa Bermejo Sáiz; Sandra Serrano Martínez; Fernando Ruiz Laiglesia; José A Nieto Rodríguez; Juan I Pérez-Calvo
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Publication Detail:
Type:  Journal Article     Date:  2011-01-05
Journal Detail:
Title:  European journal of internal medicine     Volume:  22     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  167-71     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Internal Medicine Service, Hospital Virgen de la Luz, Cuenca, Spain.
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