Prognostic prediction in acute heart failure patients with extreme BNP values

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-ye...

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Bibliographic Details
Published in:Biomarkers 2017-11, Vol.22 (8), p.715-722
Main Authors: Lourenço, Patrícia, Ribeiro, Ana, Pintalhão, Mariana, Cunha, Filipe M., Pereira, Joana, Marques, Pedro, Vilaça, João Pedro, Amorim, Marta, Silva, Sérgio, Bettencourt, Paulo
Format: Article
Language:English
Subjects:
Acute Disease
Acute heart failure
Aged
Aged, 80 and over
Biomarkers - metabolism
Female
Heart Failure - diagnosis
Heart Failure - metabolism
Heart Failure - physiopathology
Humans
Male
Middle Aged
Natriuretic Peptide, Brain - metabolism
natriuretic peptides
Prognosis
Prospective Studies
Reference Values
Registries - statistics & numerical data
relative insufficiency
ROC Curve
Stroke Volume
Survival Analysis
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Summary: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 400 pg/mL); and among non-survivors those with high vs not-high BNP (cut-off 2000 pg/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
ISSN:1354-750X
1366-5804
DOI:10.1080/1354750X.2017.1289243