| Serial NT-proBNP monitoring and outcomes in outpatients with decompensation of heart failure. | |
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MedLine Citation:
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PMID: 17174423 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article Date: 2006-12-15 |
Journal Detail:
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Title: International journal of cardiology Volume: 120 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-07-23 Completed Date: 2007-10-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 338-43 Citation Subset: IM |
Affiliation:
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Hospital Santa Creu i Sant Pau, Barcelona, Spain. abayesgenis@santpau.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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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:
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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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