1. NT-ProBNP reduction percentage during hospital stay predicts long-term mortality and readmission in heart failure patients
- Author
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Carlo Nozzoli, Chiara Lombardo, Agostino Ognibene, Francesca Bacci, Alessandro Terreni, Maria Serena Rutili, and Valerio Verdiani
- Subjects
Male ,medicine.medical_specialty ,medicine.drug_class ,Patient Readmission ,Sensitivity and Specificity ,Predictive Value of Tests ,Internal medicine ,Natriuretic Peptide, Brain ,Natriuretic peptide ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Heart Failure ,Receiver operating characteristic ,business.industry ,Area under the curve ,General Medicine ,Brain natriuretic peptide ,medicine.disease ,Peptide Fragments ,Hospitalization ,Italy ,ROC Curve ,Predictive value of tests ,Heart failure ,Emergency medicine ,Multivariate Analysis ,Cardiology ,Long term mortality ,Female ,Cardiology and Cardiovascular Medicine ,business ,hormones, hormone substitutes, and hormone antagonists ,Follow-Up Studies - Abstract
We prospectively evaluated whether the N-terminal brain natriuretic peptide (NT-ProBNP) reduction percentage, during hospitalization for acutely decompensated heart failure (HF), has a prognostic significance in 6-month follow-up. In 120 patients consecutively admitted for acute HF to an internal medicine unit, plasma NT-ProBNP was measured on admission and at discharge. During a 6-month follow-up 52 (43.3%) patients had events: 9 (7.5%) died from cardiovascular causes, and 43 (35.8%) were readmitted for HF. In patients without events, the mean reduction percentage of NT-ProBNP was greater than in patients with events (39.5 +/- 7.4 versus 26.3 +/- 5.9%; P = 0.04). In receiver operating characteristic curve analysis, the mean area under the curve for NT-ProBNP reduction percentage was 0.63 (95% CI, 0.51-0.75; P = 0.04) for the composite end point (death or readmission), and 0.81 (95% CI, 0.65-0.97, P = 0.01) for cardiovascular mortality. NT-ProBNP reduction percentage less than 30% was the best cut-off for the identification of patients at risk of events. We suggest that in clinical practice the evaluation of change of NT-ProBNP levels during admission is probably more helpful than predischarge NT-ProBNP absolute value.
- Published
- 2008