Document Detail


Usefulness of clinical and NT-proBNP monitoring for prognostic guidance in destabilized heart failure outpatients.
MedLine Citation:
PMID:  18263871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To study the relative prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) monitoring in addition to clinical disease severity scores (CDSSs) in outpatients with destabilized heart failure (HF). METHODS AND RESULTS: Seventy-one outpatients with recently destabilized HF were recruited. At baseline, and at all following visits, a CDSS based on Framingham criteria was obtained, and NT-proBNP levels were measured in a blind fashion. CDSS did not correlate with NT-proBNP levels at any time (P > 0.1), although their relative changes correlated during follow-up (P < 0.001). Forty patients (56%) had clinical events (cardiovascular death and/or HF hospitalization) within 1 year of follow-up. Changes in CDSS from baseline were not predictive of subsequent events (P > 0.1 for all visits), whereas changes in NT-proBNP levels were predictive at several time points: week 2 (P = 0.005), week 3 (P = 0.037), week 4 (P = 0.015), and 6 months (P = 0.026). A change in NT-proBNP levels at follow-up week 2 (%) added independent prognostic information (P < 0.001, HR 0.982, 95% CI 0.972-0.992) to baseline CDSS (P = 0.002, HR 2.05, 95% CI 1.290-3.266), age (P = 0.007, HR 1.034, 95% CI 1.009-1.059), and left ventricular ejection fraction (P = 0.013, HR 0.942, 95% CI 0.898-0.987). CONCLUSION: Serial monitoring for per cent change in NT-proBNP concentrations offers superior prognostic information to clinical assessment among outpatients with recent destabilized HF.
Authors:
Domingo A Pascual-Figal; Maite Domingo; Teresa Casas; Ignasi Gich; Jordi Ordoñez-Llanos; Pedro Martínez; Juan Cinca; Mariano Valdés; James L Januzzi; Antoni Bayes-Genis
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-02-09
Journal Detail:
Title:  European heart journal     Volume:  29     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-15     Completed Date:  2008-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1011-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena s/n, 30120 Murcia, Spain. dapascual@servicam.com
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Epidemiologic Methods
Female
Heart Failure / blood*,  mortality
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Outpatients
Peptide Fragments / blood*
Prognosis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
Eur Heart J. 2008 Apr;29(8):959-60   [PMID:  18349028 ]

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