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Prognostic value of NT-proBNP added to clinical parameters to predict two-year prognosis of chronic heart failure patients with mid-range and reduced ejection fraction - A report from FAR NHL prospective registry.
Spinar, Jindrich; Spinarova, Lenka; Malek, Filip; Ludka, Ondrej; Krejci, Jan; Ostadal, Petr; Vondrakova, Dagmar; Labr, Karel; Spinarova, Monika; Pavkova Goldbergova, Monika; Benesova, Klara; Jarkovsky, Jiri; Parenica, Jiri.
Afiliación
  • Spinar J; Department of Cardiology, University Hospital Brno, Brno, Czech Republic.
  • Spinarova L; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Malek F; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Ludka O; First Department of Internal Medicine, Cardiology and Angiology, St Anne's University Hospital Brno, Brno, Czech Republic.
  • Krejci J; Department of Cardiology, Hospital Na Homolce, Prague, Czech Republic.
  • Ostadal P; Department of Cardiology, University Hospital Brno, Brno, Czech Republic.
  • Vondrakova D; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Labr K; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Spinarova M; First Department of Internal Medicine, Cardiology and Angiology, St Anne's University Hospital Brno, Brno, Czech Republic.
  • Pavkova Goldbergova M; Department of Cardiology, Hospital Na Homolce, Prague, Czech Republic.
  • Benesova K; Department of Cardiology, Hospital Na Homolce, Prague, Czech Republic.
  • Jarkovsky J; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Parenica J; First Department of Internal Medicine, Cardiology and Angiology, St Anne's University Hospital Brno, Brno, Czech Republic.
PLoS One ; 14(3): e0214363, 2019.
Article en En | MEDLINE | ID: mdl-30913251
ABSTRACT

BACKGROUND:

According to guidelines, the prognosis of patients with chronic heart failure can be predicted by determining the levels of natriuretic peptides, the NYHA classification and comorbidities. The aim our work was to develop a prognostic score in chronic heart failure patients that would take account of patients' comorbidities, NYHA and NT-proBNP levels. METHODS AND

RESULTS:

A total of 1,088 patients with chronic heart failure with reduced ejection fraction (HFrEF) (LVEF<40%) and mid-range EF (HFmrEF) (LVEF 40-49%) were enrolled consecutively. Two-year all-cause mortality, heart transplantation and/or LVAD implantation were defined as the primary endpoint (EP). The occurrence of EP was 14.9% and grew with higher NYHA, namely 4.9% (NYHA I), 11.4% (NYHA II) and 27.8% (NYHA III-IV) (p<0.001). The occurrence of EP was 3%, 10% and 15-37% in patients with NT-proBNP levels ≤125 ng/L, 126-1000 ng/L and >1000 ng/L respectively. Discrimination abilities of NYHA and NT-proBNP were AUC 0.670 (p<0.001) and AUC 0.722 (p<0.001) respectively. The predictive value of the developed clinical model, which took account of older age, advanced heart failure (NYHA III+IV), anaemia, hyponatraemia, hyperuricaemia and being on a higher dose of furosemide (>40 mg daily) (AUC 0.773; p<0.001) was increased by adding the NT-proBNP level (AUC 0.790).

CONCLUSION:

The use of prediction models in patients with chronic heart failure, namely those taking account of natriuretic peptides, should become a standard in routine clinical practice. It might contribute to a better identification of a high-risk group of patients in which more intense treatment needs to be considered, such as heart transplantation or LVAD implantation.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 6_ODS3_enfermedades_notrasmisibles Problema de salud: 6_cardiovascular_diseases / 6_other_circulatory_diseases Asunto principal: Fragmentos de Péptidos / Volumen Sistólico / Péptido Natriurético Encefálico / Insuficiencia Cardíaca Tipo de estudio: Guideline / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: República Checa

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 6_ODS3_enfermedades_notrasmisibles Problema de salud: 6_cardiovascular_diseases / 6_other_circulatory_diseases Asunto principal: Fragmentos de Péptidos / Volumen Sistólico / Péptido Natriurético Encefálico / Insuficiencia Cardíaca Tipo de estudio: Guideline / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: República Checa
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