The prognostic value of brain natriuretic peptide (BNP) in non-cardiac patients with sepsis, ultra-long follow-up

Khoury, Johad; Arow, Majd; Elias, Adi; Makhoul, Badira F.; Berger, Gidon; Kaplan, Marielle; Mashiach, Tanya; Ismael-Badarneh, Reem; Aronson, Doron; Azzam, Zaher S.

doi:10.1016/j.jcrc.2017.07.009

Cited by 27 publications

(23 citation statements)

References 35 publications

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“…4 Furthermore, the use of cardiac biomarkers in risk scoring systems is worthy of further study. Khoury et al 72 found the BNP level at admission to be more predictive of short-term mortality than the Sequential Organ Failure Assessment score. In contrast, Ryoo et al 46 reported that the combination of BNP with the Sequential Organ Failure Assessment score resulted in better prognostication in patients with sepsis than either method alone.…”

Section: Discussionmentioning

confidence: 99%

Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

Vallabhajosyula

Wang

Murad

et al. 2020

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Data are conflicting regarding the optimal cutoffs of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) to predict short-term mortality in patients with sepsis. We conducted a comprehensive search of several databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus) for English-language reports of studies evaluating adult patients with sepsis, severe sepsis, and septic shock with BNP/NT-proBNP levels and short-term mortality (intensive care unit, in-hospital, 28-day, or 30-day) published from January 1, 2000, to September 5, 2017. The average values in survivors and nonsurvivors were used to estimate the receiver operating characteristic curve (ROC) using a parametric regression model. Thirty-five observational studies (3508 patients) were included (median age, 51-75 years; 12%-74% males; cumulative mortality, 34.2%). A BNP of 622 pg/mL had the greatest discrimination for mortality (sensitivity, 0.695 [95% CI, 0.659-0.729]; specificity, 0.907 [95% CI, 0.810-1.003]; area under the ROC, 0.766 [95% CI, 0.734-0.797]). An NT-proBNP of 4000 pg/mL had the greatest discrimination for mortality (sensitivity, 0.728 [95% CI, 0.703-0.753]; specificity, 0.789 [95% CI, 0.710-0.867]; area under the ROC, 0.787 [95% CI, 0.766-0.809]). In prespecified subgroup analyses, identified BNP/NT-proBNP cutoffs had higher discrimination if specimens were obtained 24 hours or less after admission, in patients with severe sepsis/ septic shock, in patients enrolled after 2010, and in studies performed in the United States and Europe. There was inconsistent adjustment for renal function. In this hypothesis-generating analysis, BNP and NT-proBNP cutoffs of 622 pg/mL and 4000 pg/mL optimally predicted short-term mortality in patients with sepsis. The applicability of these results is limited by the heterogeneity of included patient populations.

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Section: Discussionmentioning

confidence: 99%

Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

Vallabhajosyula

Wang

Murad

et al. 2020

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…For example, Papanikolaou et al showed day-1 BNP of >800 pg/ml predicting mortality with area under the curve (AUC) value 0.7 (95% CI: 0.54-0.86) [ 22 ]. Similarly, Khoury et al concluded that admission plasma BNP above 1,000 pg/ml independently predicted short- and long-term mortality in hospitalized patients with sepsis and septic shock [ 23 ]. The prognostic value of elevated BNP concentration regarding in-hospital mortality and length of hospital stay has been established regardless of the presence of cardiac dysfunction [ 24 ].…”

Section: Reviewmentioning

confidence: 99%

The Role of Brain Natriuretic Peptide as a Prognostic Marker for Sepsis

Bhandari

Cunningham

2020

Cureus

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Brain natriuretic peptide (BNP) is a neurohormone released in response to volume expansion and increased pressure. It is commonly used to assist in the diagnosis and management of heart failure. BNP can also play an important role as a biomarker in septic shock; however, elevations of BNP in conditions other than sepsis or cardiac dysfunction limits its use as the sole prognostic marker in patients hospitalized with sepsis. Further relationships regarding laboratory value and correlation with severity of illness need to be established with larger prospective studies to develop consensus regarding a cutoff point for optimum sensitivity and specificity in predicting in-hospital mortality related to sepsis.

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“…BNP and its inactive cleavage product, N-terminal pro-BNP (NT-proBNP), are derived from the cleavage of BNP precursors. NT-proBNP has a longer half-life and more stable biological characteristics than BNP, making it more suitable for clinical application [6,7]. Plasma NT-proBNP has been widely used as an important biomarker of increased left ventricular filling pressure and left ventricular dysfunction [8,9].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of N-terminal Probrain Natriuretic Peptide for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Lin

2020

BioMed Research International

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Objectives. The mortality rate of patients with acute respiratory distress syndrome (ARDS) is high. Hence, it is crucial to identify a reliable biomarker with wide clinical applications for predicting the prognosis of patients with ARDS. This systematic review and meta-analysis was conducted to investigate the value of plasma N-terminal probrain natriuretic peptide (NT-proBNP) for predicting mortality in patients with ARDS. Methods. An electronic search of databases including PubMed, Web of Science, Cochrane Library, and Chinese National Knowledge Infrastructure was conducted up to May 31, 2019, without language restrictions. The quality of the included studies was evaluated using QUADAS-2. Data were extracted and analyzed to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. A forest graph was used to evaluate heterogeneity. Potential causes of heterogeneity were further explored by subgroup analysis based on the testing day, testing method, observation endpoint, or cut-off points. A summary receiver operating characteristic curve was drawn to obtain the pooled area under the curve. Results. A total of 7 studies involving 581 patients with ARDS were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were as follows: 0.79 (95% CI: 0.72–0.84), 0.79 (95% CI: 0.66–0.88), 3.68 (95% CI: 2.16–6.28), 0.27 (95% CI: 0.20–0.38), and 13.58 (95% CI: 6.17–29.90), respectively. The results of subgroup analysis showed that the testing day influenced the summary sensitivity and that the cut-off points influenced the summary sensitivity and specificity. Conclusion. Our results indicate that elevated plasma NT-proBNP levels have a moderate value for predicting the mortality of patients with ARDS.

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The prognostic value of brain natriuretic peptide (BNP) in non-cardiac patients with sepsis, ultra-long follow-up

Cited by 27 publications

References 35 publications

Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

The Role of Brain Natriuretic Peptide as a Prognostic Marker for Sepsis

Prognostic Value of N-terminal Probrain Natriuretic Peptide for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

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