Document Detail


Serial NT-proBNP monitoring and outcomes in outpatients with decompensation of heart failure.
MedLine Citation:
PMID:  17174423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: NT-proBNP is useful for heart failure (HF) diagnosis and prognosis. We examined the value of serial NT-proBNP monitoring to predict outcomes in decompensated HF patients attending a structured HF clinic. METHODS: Patients with decompensation of established optimally treated HF, not requiring emergency hospital admission, were enrolled in the study. Patients received intensive follow-up weekly during 4 weeks and at 3 months in specialist HF clinics. Serial NT-proBNP concentrations were measured at each visit. Primary endpoint was cardiovascular death and hospital admission for HF at 3 months. RESULTS: Fifty-nine patients were enrolled (60+/-14 years, LVEF 27+/-9%) and 39% had a primary endpoint during follow-up. Baseline NT-proBNP concentration (in ng/L) was 7050+/-6620, and did not differ significantly in patients with and without events (p=0.22). Patients without events showed marked NT-proBNP reduction at week-1 (30% reduction), week-2 (36% reduction), week-3 (34% reduction) and week-4 (37% reduction). By contrast, patients with events showed no significant NT-proBNP reduction during follow-up. Using a general linear model, the relative NT-proBNP reductions (%) at weeks 1-4 were predictors of adverse events (p=0.004, p<0.001, p=0.001 and p=0.03, respectively). In a stepwise multiple Cox regression analysis, NT-proBNP relative reduction (in %) at week 2 was a strong predictor of no events during follow-up (OR 0.79, 95% CI 0.70-0.88, p<0.001). CONCLUSIONS: Serial NT-proBNP monitoring in decompensated HF patients seen in a structured in-hospital HF clinic predicts cardiovascular events during follow-up. NT-proBNP may be useful in an outpatient basis to identify patients at high risk needing more aggressive therapy.
Authors:
Antoni Bayes-Genis; Domingo Pascual-Figal; Jordi Fabregat; Maite Domingo; Francesc Planas; Teresa Casas; Jordi Ordoñez-Llanos; Mariano Valdes; Juan Cinca
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Publication Detail:
Type:  Journal Article     Date:  2006-12-15
Journal Detail:
Title:  International journal of cardiology     Volume:  120     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-07-23     Completed Date:  2007-10-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  338-43     Citation Subset:  IM    
Affiliation:
Hospital Santa Creu i Sant Pau, Barcelona, Spain. abayesgenis@santpau.es
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Biological Markers / blood
Diuretics / therapeutic use
Female
Follow-Up Studies
Heart Failure / blood*,  drug therapy,  mortality*
Hemoglobins / analysis
Humans
Linear Models
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Outpatient Clinics, Hospital
Patient Admission / statistics & numerical data*
Peptide Fragments / blood*
Predictive Value of Tests
Sensitivity and Specificity
Spain / epidemiology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Biological Markers; 0/Diuretics; 0/Hemoglobins; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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