Pronóstico de NT-proBNP en insuficiencia cardíaca con fracción de eyección preservada, media y reducida
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Date
Subject
NT-proBNP
heart failure
mortality
prognostic
cardiovascular
NT-proBNP
insuficiencia cardíaca
pronóstico de mortalidad
heart failure
mortality
prognostic
cardiovascular
NT-proBNP
insuficiencia cardíaca
pronóstico de mortalidad
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Journal Title
Journal ISSN
Volume Title
Publisher
Intituto Tecnológico de Santo Domingo (INTEC)
Objetivo. El valor pronóstico del péptido natriurético procerebral N-terminal (NT-proBNP) en pacientes con insuficiencia cardíaca (IC) está bien establecido. En cambio, su papel como predictor temprano de mortalidad en pacientes hospitalizados por insuficiencia cardíaca con fracción de eyección conservada (IC-FEc) e insuficiencia cardíaca con fracción de eyección reducida (IC-FEr) está menos documentado. Por tanto, el objetivo de este estudio es evaluar la utilidad y valor pronóstico del NT-proBNP plasmático en estos pacientes.
Método. Este estudio observacional retrospectivo incluyó a 620 pacientes ingresados por insuficiencia cardíaca aguda, clasificados en 3 grupos según su fracción de eyección del ventrículo izquierdo (FEVI): IC-FEc (FEVI ≥ 50%), IC-FEm (insuficiencia cardíaca con fracción de eyección media) (FEVI 35-49%) e IC-FEr (FEVI <40 %), cuyos niveles plasmáticos de NT-proBNP y datos clínicos se determinaron al ingreso hospitalario. Se utilizó regresión logística univariada y multivariante para realizar los valores pronósticos de los niveles de NT-proBNP para 3.4 años de mortalidad por todas las causas en cada grupo.
Resultados. Los niveles plasmáticos medios de NT-proBNP en pacientes con IC-FEc (35%) y IC-FEc limítrofe (43%) fue de 1001-5000 pg / ml; los pacientes con IC-FEr se distribuyeron de manera similar entre los grupos 1001-5000pg / ml (30%), 5001-15000pg / ml (31%) y > 15001pg / ml (30. 6%). La tasa de mortalidad aumentó significativamente en pacientes con concentraciones de NT-proBNP >15001 pg / ml (40%) y disminuyó con niveles de NT-proBNP <250 pg / ml (4%), en comparación con los otros grupos de NT-proBNP. La tasa de mortalidad aumentó proporcionalmente a los valores basales elevados de NT-proBNP, independientemente de la FEVI.
Conclusión. En pacientes hospitalizados por evento agudo desestabilizado con IC-FEc (FEVI ≥50%) y IC-FEm (FEVI 35-49%) los niveles plasmáticos de NT-proBNP son una herramienta útil para predecir la mortalidad temprana como lo es para la IC-FEr (FEVI <40%).
Objective. The prognostic value of N-terminal procerebral natriuretic peptide (NT-proBNP) in patients with heart failure (HF) is well established. In contrast, its role as an early predictor of mortality in patients hospitalized for heart failure with preserved ejection fraction (HF-EF) and heart failure with reduced ejection fraction (HF-EF) is less well documented. Therefore, the objective of this study is to evaluate the usefulness and prognostic value of plasma NT-proBNP in these patients. Method. This retrospective observational study included 620 patients admitted for acute heart failure, classified into 3 groups according to their left ventricular ejection fraction (LVEF): HF-EF (LVEF ≥ 50%), HF-mEF (heart failure with ejection fraction mean) (LVEF 35-49%) and HF-rEF (LVEF <40%), whose plasma levels of NT-proBNP and clinical data were determined at hospital admission. Univariate and multivariate logistic regression was used to perform prognostic values of NT-proBNP levels for 3.4 years of all-cause mortality in each group. Results: The mean plasma levels of NT-proBNP in patients with HF-cEF (35%) and borderline HF-cEF (43%) was 1001-5000 pg / ml; patients with HF-rEF were similarly distributed between the groups 1001-5000pg / ml (30%), 5001-15000pg / ml (31%) and> 15001pg / ml (30.6%). The mortality rate increased significantly in patients with NT-proBNP concentrations > 15001 pg / ml (40%) and decreased with NT-proBNP levels <250 pg / ml (4%), compared to the other NT-proBNP groups. The mortality rate increased proportionally to elevated baseline NT-proBNP, regardless of LVEF. Conclusion. In patients hospitalized for an acute decompensated event with HF-cEF (LVEF ≥50%) and HF-mEF (LVEF 35-49%), plasma levels of NT-proBNP are a useful tool to predict early mortality, as for HF -FEr (LVEF <40%).
Objective. The prognostic value of N-terminal procerebral natriuretic peptide (NT-proBNP) in patients with heart failure (HF) is well established. In contrast, its role as an early predictor of mortality in patients hospitalized for heart failure with preserved ejection fraction (HF-EF) and heart failure with reduced ejection fraction (HF-EF) is less well documented. Therefore, the objective of this study is to evaluate the usefulness and prognostic value of plasma NT-proBNP in these patients. Method. This retrospective observational study included 620 patients admitted for acute heart failure, classified into 3 groups according to their left ventricular ejection fraction (LVEF): HF-EF (LVEF ≥ 50%), HF-mEF (heart failure with ejection fraction mean) (LVEF 35-49%) and HF-rEF (LVEF <40%), whose plasma levels of NT-proBNP and clinical data were determined at hospital admission. Univariate and multivariate logistic regression was used to perform prognostic values of NT-proBNP levels for 3.4 years of all-cause mortality in each group. Results: The mean plasma levels of NT-proBNP in patients with HF-cEF (35%) and borderline HF-cEF (43%) was 1001-5000 pg / ml; patients with HF-rEF were similarly distributed between the groups 1001-5000pg / ml (30%), 5001-15000pg / ml (31%) and> 15001pg / ml (30.6%). The mortality rate increased significantly in patients with NT-proBNP concentrations > 15001 pg / ml (40%) and decreased with NT-proBNP levels <250 pg / ml (4%), compared to the other NT-proBNP groups. The mortality rate increased proportionally to elevated baseline NT-proBNP, regardless of LVEF. Conclusion. In patients hospitalized for an acute decompensated event with HF-cEF (LVEF ≥50%) and HF-mEF (LVEF 35-49%), plasma levels of NT-proBNP are a useful tool to predict early mortality, as for HF -FEr (LVEF <40%).
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Type
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/publishedVersion
Source
Science and Health; Vol. 5 No. 3 (2021): Science and Health, september-december; 5-12
Ciencia y Salud; Vol. 5 Núm. 3 (2021): Ciencia y Salud, septiempre-diciembre; 5-12
2613-8824
2613-8816
10.22206/cysa.2021.v5i3
Ciencia y Salud; Vol. 5 Núm. 3 (2021): Ciencia y Salud, septiempre-diciembre; 5-12
2613-8824
2613-8816
10.22206/cysa.2021.v5i3