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Báo cáo y học: "Direct comparison of serial B-type natriuretic peptide and NT-proBNP levels for prediction of short- and long-term outcome in acute decompensated heart failure"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Direct comparison of serial B-type natriuretic peptide and NT-proBNP levels for prediction of short- and long-term outcome in acute decompensated heart failure. | Noveanu et al. Critical Care 2011 15 R1 http ccforum.eom content 15 1 R1 KS CRITICAL CARE RESEARCH Open Access Direct comparison of serial B-type natriuretic peptide and NT-proBNP levels for prediction of short- and long-term outcome in acute decompensated heart failure 1.2 12 2 11 Markus Noveanu 1 Tobias Breidthardt Mihael Potocki Tobias Reichlin Raphael Twerenbold Heiko Uthoff 11 1 1 1 1 1 Thenral Socrates Nisha Arenja Miriam Reiter Julia Meissner Corinna Heinisch Sybille Stalder Christian Mueller Abstract Introduction Monitoring treatment efficacy and assessing outcome by serial measurements of natriuretic peptides in acute decompensated heart failure ADHF patients may help to improve outcome. Methods This was a prospective multi-center study of 1 7 1 consecutive patients mean age 80 73-85 years presenting to the emergency department with ADHF. Measurement of BNP and NT-proBNP was performed at presentation 24 hours 48 hours and at discharge. The primary endpoint was one-year all-cause mortality secondary endpoints were 30-days all-cause mortality and one-year heart failure HF readmission. Results During one-year follow-up a total of 60 35 patients died. BNP and NT-proBNP levels were higher in non-survivors at all time points all P 0.001 . In survivors treatment reduced BNP and NT-proBNP levels by more than 50 P 0.001 while in non-survivors treatment did not lower BNP and NT-proBNP levels. The area under the ROC curve AUC for the prediction of one-year mortality increased during the course of hospitalization for BNP AUC presentation 0.67 AUC 24 h 0.77 AUC 48 h 0.78 AUC discharge 0.78 and NT-proBNP AUC presentation 0.67 AUC 24 h 0.73 AUC 48 h 0.75 AUC discharge 0.77 . In multivariate analysis BNP at 24 h 1.02 1.01-1.04 P 0.003 48 h 1.04 1.02-1.06 P 0.001 and discharge 1.02 1.01-1.03 P 0.001 independently predicted one-year mortality while only pre-discharge NT-proBNP was predictive 1.07 1.01-1.13 P 0.016 . Comparable results could be obtained for the secondary .