Changes of Natriuretic Peptides Predict Hospital Admissions in Patients With Chronic Heart Failure: A Meta-Analysis

Savarese, Gianluigi; Musella, Francesca; D’Amore, Carmen; Vassallo, Enrico; Losco, Teresa; Cecere, Milena; Petraglia, Laura; Trimarcö, Bruno; Perrone‐Filardi, Pasquale

doi:10.1016/s0735-1097(14)60737-3

Cited by 27 publications

(40 citation statements)

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“…The annual increase before the occurrence of death or heart failure was ≈25% of the baseline value, and may therefore be considered clinically meaningful. This is in line with previous studies in patients with chronic heart failure, showing that changes in NT‐proBNP level over time are associated with an individual's prognosis …”

Section: Discussionsupporting

confidence: 93%

“…Most of the studies that have evaluated repeated NT‐proBNP measurements to date, have assessed the difference between two subsequent NT‐proBNP measurements and related relative, absolute and/or categorical changes to adverse events . This is the first time that multiple repeated NT‐proBNP values are investigated, and that JM techniques are applied.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic Value of Serial N‐Terminal Pro‐B‐Type Natriuretic Peptide Measurements in Adults With Congenital Heart Disease

Baggen

Baart

Bosch

et al. 2018

JAHA

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BackgroundA single NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) measurement is a strong prognostic factor in adult congenital heart disease. This study investigates NT‐proBNP profiles within patients with adult congenital heart disease and relates these to cardiovascular events.Methods and ResultsIn this prospective cohort, 602 patients with adult congenital heart disease were enrolled at the outpatient clinic (years 2011–2013). NT‐proBNP was measured at study inclusion in 595 patients (median age 33 [IQR 25–41] years, 58% male, 90% NYHA I) and at subsequent annual visits. The primary end point was defined as death, heart failure, hospitalization, arrhythmia, thromboembolic event, or cardiac intervention; the secondary end point as death or heart failure. Repeated measurements were analyzed using linear mixed models and joint models. During a median follow‐up of 4.4 [IQR 3.8–4.8] years, a total of 2424 repeated measurements were collected. Average NT‐proBNP increase was 2.9 pmol/L the year before the primary end point (n=199, 34%) and 18.2 pmol/L before the secondary end point (n=58, 10%), compared with 0.3 pmol/L in patients who remained end point‐free (P‐value for difference in slope 0.006 and <0.001, respectively). In patients with elevated baseline NT‐proBNP (>14 pmol/L, n=315, 53%), repeated measurements were associated with the primary end point (HR per 2‐fold higher value 2.08; 95% CI 1.31–3.87; P<0.001) and secondary end point (HR 2.47; 95% CI 1.13–5.70; P=0.017), when adjusted for the baseline measurement.Conclusions NT‐proBNP increased before the occurrence of events, especially in patients who died or developed heart failure. Serial NT‐proBNP measurements could be of additional prognostic value in the annual follow‐up of patients with adult congenitive heart disease with an elevated NT‐proBNP.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Serial N‐Terminal Pro‐B‐Type Natriuretic Peptide Measurements in Adults With Congenital Heart Disease

Baggen

Baart

Bosch

et al. 2018

JAHA

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“…Istnieją z kolei dowody wskazujące, że pomiary NP przy przyjęciu do szpitala mogą pomóc w planowaniu wypisu. Pacjenci, u których dochodzi do spadku osoczowych stężeń NP w trakcie przyjęcia, charakteryzują się niższą śmiertelno-ścią sercowo-naczyniową i mniejszym ryzykiem ponownej hospitalizacji w ciągu 6 miesięcy [588][589][590].…”

Section: Terapia Doustna O Udokumentowanejunclassified

“…Wysokie stężenia krążących NP mają znaczenie rokownicze u pacjentów z HF, a spadek ich osoczowych stężeń w okresie poprawy po epizodzie dekompensacji wiąże się z lepszym rokowaniem [588][589][590]. Chociaż monitorowanie stanu klinicznego i dostosowywanie leczenia na podstawie zmian osoczowych stężeń NP jest akceptowalne u pacjentów z HF, dostępne w piśmiennictwie dane nie są jednoznaczne [635][636][637][638].…”

Section: Obserwacja Odległa I Monitorowanieunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

453

446

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“…Biomarkers are evaluated whether they could play a role in disease management strategies [25]. The most studied and established HF biomarkers are high-sensitivity troponin T (hsTnT) and N-terminal pro-B-type natriuretic peptide (NTproBNP) [26], which indicate myocyte injury and wall stress, respectively.…”

Section: Differentiating In Hf Phenotypementioning

confidence: 99%

New developments in the pharmacotherapeutic management of heart failure in elderly patients: concerns and considerations

Screever

Meijers

Veldhuisen

et al. 2017

Expert Opinion on Pharmacotherapy

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Introduction: Heart failure (HF) remains a major public health problem worldwide, affecting approximately 23 million patients, and is predominantly a disease of the elderly population. Elderly patients mostly suffer from HF with preserved ejection fraction (HFpEF), which often presents with multiple comorbidities and they require multiple medical treatments. This, together with the heterogeneous phenotype of HFpEF, makes it a difficult syndrome to diagnose and treat. Areas covered: Although HF is most abundant in the elderly, this group is still underrepresented in clinical trials, which results in the lack of evidence-based medical regimens. The current review has focused on new potential therapies for this poorly studied population. The focus will be on several classes of drugs currently recommended or might be expected soon. These will include sacubitril/ valsartan (former LCZ696), Omecamtiv mecarbil, Vericiguat, Ivabradine, mineralocorticoid receptor antagonists (MRAs) and potassium binders. Expert opinion: We discuss promising new treatments and hypothesize that personalized approaches will be needed to treat elderly patients optimally. Medical doctors should not only focus on HF therapy, but comorbidities and polypharmacy should also influence therapeutic decision making. Furthermore, the importance of quality of life as a management endpoint should not be underestimated in the frail elderly. ARTICLE HISTORY

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Changes of Natriuretic Peptides Predict Hospital Admissions in Patients With Chronic Heart Failure: A Meta-Analysis

Cited by 27 publications

References 0 publications

Prognostic Value of Serial N‐Terminal Pro‐B‐Type Natriuretic Peptide Measurements in Adults With Congenital Heart Disease

Prognostic Value of Serial N‐Terminal Pro‐B‐Type Natriuretic Peptide Measurements in Adults With Congenital Heart Disease

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

New developments in the pharmacotherapeutic management of heart failure in elderly patients: concerns and considerations

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