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The Predictivity of N-Terminal Pro b-Type Natriuretic Peptide for All-Cause Mortality in Various Follow-Up Periods among Heart Failure Patients

1
Department of Nursing, Saint Mary’s Hospital Luodong, Luodong, Yilan 26546, Taiwan
2
Department of Nephrology, Department of Internal medicine, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
3
Department of Biological Science and Technology, Chung Hwa University of Medical Technology, Rende District, Tainan City 717, Taiwan
4
Division of Cardiovascular Medicine, Department of Internal Medicine, Saint Mary’s Hospital Luodong, Luodong, Yilan 26546, Taiwan
5
Division of Nephrology, Department of Internal Medicine, Saint Mary’s Hospital Luodong, Luodong, Yilan 26546, Taiwan
6
Saint Mary’s Junior College of Medicine, Nursing and Management, Sanxing Township, Yilan County 266, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(3), 357; https://doi.org/10.3390/jcm8030357
Received: 10 February 2019 / Revised: 2 March 2019 / Accepted: 9 March 2019 / Published: 13 March 2019
(This article belongs to the Special Issue Acute and Chronic Heart Failure)
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PDF [1675 KB, uploaded 13 March 2019]
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Abstract

Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) is an excellent prognostic–predictive tool in heart failure (HF) patients, but its plasma level changes following therapy. The comparison of prognosis–predictivity of a single measurement of plasma NT-pro BNP in different follow-up periods in acute HF patients has been less studied. This study aimed to evaluate whether the association between initial plasma NT-proBNP levels and all-cause mortality would decrease along with an increased follow-up period in patients with acute HF. The retrospective study was carried out, enrolling adult patients with hospitalization-requiring acute HF who fulfilled the predefined criteria from January 1, 2011, to December 31, 2013. We evaluated the independent predictors of 12-month mortality, and subsequently compared the predictivity of NT-proBNP level at initial presentation for 1-, 3-, 6-, 9- and 12-month mortality. In total, 269 patients (mean age, 74.45 ± 13.59 years; female, 53.9%) were enrolled. The independent predictors of 12-month mortality included higher “Charlson Comorbidity Index” (adjusted hazard ratio (aHR) = 1.22; 95% confidence interval (CI), 1.10–1.34), increased “age” (aHR = 1.07; 95% CI, 1.04–1.10), “administration of vasopressor” (aHR = 3.43; 95% CI, 1.76–6.71), “underwent cardiopulmonary resuscitation” (aHR = 4.59; 95% CI, 1.76–6.71), and without “angiotensin-converting enzyme inhibitors/angiotensin receptor blocker” (aHR = 0.41; 95% CI, 1.86–11.31) (all p <0.001). “Plasma NT-pro BNP level ≧11,755 ng/L” was demonstrated as an independent predictor in 1-month (aHR = 2.37; 95% CI, 1.10–5.11; p = 0.028) and 3-month mortality (aHR = 1.98; 95% CI, 1.02–3.86; p = 0.045) but not in more extended follow-up. The outcome predictivity of plasma NT-proBNP levels diminished in a longer follow-up period in hospitalized acute HF patients. In conclusion, these findings remind physicians to act with caution when using a single plasma level of NT-proBNP to predict patient outcomes with a longer follow-up period. View Full-Text
Keywords: all-cause mortality; follow-up period; heart failure; hospitalization; NT-proBNP all-cause mortality; follow-up period; heart failure; hospitalization; NT-proBNP
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Lai, M.-Y.; Kan, W.-C.; Huang, Y.-T.; Chen, J.; Shiao, C.-C. The Predictivity of N-Terminal Pro b-Type Natriuretic Peptide for All-Cause Mortality in Various Follow-Up Periods among Heart Failure Patients. J. Clin. Med. 2019, 8, 357.

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