Association of N-terminal pro-brain natriuretic peptide with contrast-induced acute kidney injury and long-term mortality in patients with heart failure and mid-range ejection fraction: An observation study.
Medicine (Baltimore)
; 96(10): e6259, 2017 Mar.
Article
en En
| MEDLINE
| ID: mdl-28272231
ABSTRACT
The potential value of N-terminal pro-brain natriuretic peptide (NT-proBNP) for contrast-induced acute kidney injury (CI-AKI) in patients with heart failure and mid-range ejection fraction (HFmrEF) is unclear. We investigated whether NT-proBNP is associated with CI-AKI and long-term mortality following elective cardiac catheterization in patients with HFmrEF.A total of 174 consecutive patients with HFmrEF undergoing elective coronary angiography or intervention were enrolled. The primary endpoint was the development of CI-AKI, defined as an absolute increase of ≥0.3âmg/dL or ≥ 50% from baseline serum creatinine with 48âhours after contrast medium exposure. Receiver-operating characteristic curve analysis was conducted, and Youden index was used to determine the best cutoff NT-proBNP value. Multivariable logistic regression and Cox proportional hazards regression analyses were performed to identify the independent risk factors for CI-AKI and long-term mortality, respectively.The incidence of CI-AKI was 12.1%. Patients with CI-AKI had higher NT-proBNP values than those without (4373[1561.9-7470.5] vs 1303[625.2-2482.3], Pâ=â0.003). Receiver-operating characteristic curve revealed that NT-proBNP was not significantly different from the Mehran risk score in predicting CI-AKI (area under the curve [AUC]â=â0.723 vs 0.767, Pâ=â0.516). The best cutoff NT-proBNP value for CI-AKI was 3299âpg/mL, with 70.6% sensitivity and 83.1% specificity. Multivariable analysis demonstrated that NT-proBNP ≥3299âpg/mL is significantly related to CI-AKI (odds ratioâ=â12.79; 95% confidence interval, 3.18-51.49; Pâ<â0.001). Cox regression analysis showed that NT-proBNP ≥3299âpg/mL is associated with long-term mortality (adjusted hazard ratioâ=â11.91; 95%CI, 2.16-65.70; Pâ=â0.004) during follow-up.In patients with HFmrEF, NT-proBNP ≥3299âpg/mL is associated with CI-AKI and long-term mortality following elective coronary angiography or intervention.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fragmentos de Péptidos
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Péptido Natriurético Encefálico
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Lesión Renal Aguda
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Insuficiencia Cardíaca
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2017
Tipo del documento:
Article