Prognostic prediction in acute heart failure patients with extreme BNP values

• Type: Article in International Scientific Journal
• Date: 2017

Authors

Lourenco, P (Author) FMUP; Ribeiro, A (Author) Other; Pintalhão M (Author) FMUP; Cunha, FM (Author) Other; Pereira, J (Author) Other; Marques, P (Author) Other; Vilaca, JP (Author) Other; Amorim, M (Author) Other; Silva, S (Author) Other; Bettencourt P (Author) FMUP

Journal

Title: Biomarkers

Vol. 22

Pages: 715-722

ISSN: 1354-750X

Publisher: Taylor & Francis

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-00N-8JH

DOI: 10.1080/1354750x.2017.1289243

Abstract (EN): Background: Some patients have good prognosis despite elevated B-type natriuretic peptide (BNP), while others have ominous outcome with low BNP. We aimed at characterising these groups of patients.Methods: We analysed patients prospectively included in an acute HF registry. Vital status within 1-year post discharge was ascertained. A receiver-operating characteristic curve was used to define discharge BNP cut-offs for 1-year death prediction. Among survivors, we compared patients with low and not-low BNP (cut-off 400pg/mL); and among non-survivors those with high vs not-high BNP (cut-off 2000pg/mL). In the specific subgroups of patients with low and high BNP, mortality predictors were assessed with multivariate Cox-regression analysis.Results: We studied 584 patients, median age 78 years, 62.5% had HF with reduced ejection fraction; and 199 (34.1%) died during the first year. Non-survivors were very homogeneous irrespective of BNP, survivors were substantially different. In patients discharged with BNP <400pg/mL, increasing age independently predicted death; when BNP 2000pg/mL death predictors were higher NYHA class, and non-use of evidence-based therapy. BNP was outcome associated in both groups.Conclusions: Different prognostic predictors may play a role in different BNP levels. We suggest that risk stratification in HF would probably be more accurate if made on top of BNP knowledge.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8