| Usefulness of clinical and NT-proBNP monitoring for prognostic guidance in destabilized heart failure outpatients. | |
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MedLine Citation:
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PMID: 18263871 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2008-02-09 |
Journal Detail:
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Title: European heart journal Volume: 29 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-04-15 Completed Date: 2008-08-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1011-8 Citation Subset: IM |
Affiliation:
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Department of Cardiology, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena s/n, 30120 Murcia, Spain. dapascual@servicam.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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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:
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0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2008 Apr;29(8):959-60
[PMID:
18349028
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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