In-hospital mortality is associated with high NT-proBNP level

Benmachiche, Malik; Marques‐Vidal, Pedro; Waeber, Gérard; Méan, Marie

doi:10.1371/journal.pone.0207118

Cited by 10 publications

(7 citation statements)

References 41 publications

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“…5 Guidelines recommend patients with symptoms suggestive of HF (breathlessness, fatigue, ankle swelling) have a natriuretic peptide (NP) blood test in primary care to determine whether, and how quickly, a specialist diagnostic assessment is required. [6][7][8][9][10][11] The National Institute for Health and Care Excellence (NICE) in England recommends echocardiography and cardiology review within 6 weeks if the NP level is raised (BNP ≥100 pg/ mL or NT-proBNP ≥400 pg/mL) and within 2 weeks for those with a high NP (BNP >400 pg/ mL or NT-proBNP >2000 pg/mL). 7 The European Society of Cardiology (ESC) has lower thresholds for referral and specialist assessment (BNP ≥35 pg/mL or NT-proBNP ≥125 pg/mL) but does not specify a time interval.…”

Section: Introductionmentioning

confidence: 99%

Natriuretic peptide level at heart failure diagnosis and risk of hospitalisation and death in England 2004–2018

Taylor

Lay-Flurrie

Ordóñez‐Mena

et al. 2021

Heart

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ObjectiveHeart failure (HF) is a malignant condition requiring urgent treatment. Guidelines recommend natriuretic peptide (NP) testing in primary care to prioritise referral for specialist diagnostic assessment. We aimed to assess association of baseline NP with hospitalisation and mortality in people with newly diagnosed HF.MethodsPopulation-based cohort study of 40 007 patients in the Clinical Practice Research Datalink in England with a new HF diagnosis (48% men, mean age 78.5 years). We used linked primary and secondary care data between 1 January 2004 and 31 December 2018 to report one-year hospitalisation and 1-year, 5-year and 10-year mortality by NP level.Results22 085 (55%) participants were hospitalised in the year following diagnosis. Adjusted odds of HF-related hospitalisation in those with a high NP (NT-proBNP >2000 pg/mL) were twofold greater (OR 2.26 95% CI 1.98 to 2.59) than a moderate NP (NT-proBNP 400–2000 pg/mL). All-cause mortality rates in the high NP group were 27%, 62% and 82% at 1, 5 and 10 years, compared with 19%, 50% and 77%, respectively, in the moderate NP group and, in a competing risks model, risk of HF-related death was 50% higher at each timepoint. Median time between NP test and HF diagnosis was 101 days (IQR 19–581).ConclusionsHigh baseline NP is associated with increased HF-related hospitalisation and poor survival. While healthcare systems remain under pressure from the impact of COVID-19, research to test novel strategies to prevent hospitalisation and improve outcomes—such as a mandatory two-week HF diagnosis pathway—is urgently needed.

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Section: Introductionmentioning

confidence: 99%

Natriuretic peptide level at heart failure diagnosis and risk of hospitalisation and death in England 2004–2018

Taylor

Lay-Flurrie

Ordóñez‐Mena

et al. 2021

Heart

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“…Another meta-analysis by Beccatini et al ( 37 ) showed that elevated values of troponin were indicator of high risk for short-term death in patients with acute PE, but the study limited his research to troponin values only and did not include NT-proBNP values. In a recent Swiss study by Benmachiche et al ( 38 ) results revealed that patients with high levels of NT-proBNP were at higher risk of in-hospital mortality and longer LOHS, regardless of their clinical characteristics. Although in other conditions like acute coronary syndrome, the level of NT-proBNP provided better predictive power than troponin ( 39 ), this difference in PE patients has still to be established.…”

Section: Discussionmentioning

confidence: 97%

Risk factors for hospital outcomes in pulmonary embolism: A retrospective cohort study

et al. 2023

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BackgroundPulmonary embolism (PE) is not only a life-threatening disease but also a public health issue with significant economic burden. The aim of the study was to identify factors—including the role of primary care—that predict length of hospital stay (LOHS), mortality and re-hospitalization within 6 months of patients admitted for PE.MethodA retrospective cohort study was conducted with patients presenting to a Swiss public hospital with PE diagnosed at the hospital between November 2018 and October 2020. Multivariable logistic and zero-truncated negative binomial regression analyses were performed to assess risk factors for mortality, re-hospitalization and LOHS. Primary care variables encompassed whether patients were sent by their general practitioner (GP) to the emergency department and whether a GP follow-up assessment after discharge was recommended. Further analyzed variables were pulmonary embolism severity index (PESI) score, laboratory values, comorbidities, and medical history.ResultsA total of 248 patients were analyzed (median 73 years and 51.6% females). On average patients were hospitalized for 5 days (IQR 3–8). Altogether, 5.6% of these patients died in hospital, and 1.6% died within 30 days (all-cause mortality), 21.8% were re-hospitalized within 6 months. In addition to high PESI scores, we detected that, patients with an elevated serum troponin, as well as with diabetes had a significantly longer hospital stay. Significant risk factors for mortality were elevated NT-proBNP and PESI scores. Further, high PESI score and LOHS were associated with re-hospitalization within 6 months. PE patients who were sent to the emergency department by their GPs did not show improved outcomes. Follow-up with GPs did not have a significant effect on re-hospitalization.ConclusionDefining the factors that are associated with LOHS in patients with PE has clinical implications and may help clinicians to allocate adequate resources in the management of these patients. Serum troponin and diabetes in addition to PESI score might be of prognostic use for LOHS. In this single-center cohort study, PESI score was not only a valid predictive tool for mortality but also for long-term outcomes such as re-hospitalization within 6 months.

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“…14 A few studies have found that BNP levels in persons suffering from ACS can correlate with the CAD severity, degree as well as TIMI flow. 15 When pro-BNP levels increase, it relates to a worsening of coronary artery disease. This is shown in one of the well-known studies, BIOMARCS.…”

Section: Sample Size Calculation and Data Analysismentioning

confidence: 99%

Frequency of multi-vessel disease and its association with N Terminal-Pro Brain Natriuretic Peptide Levels among patients with First ST-Elevation Myocardial Infarction.

Sheikh,

Sarfaraz,

Sarfaraz

et al. 2024

Nepalese Heart J.

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Background and Aims: To determine the frequency of multi-vessel disease among patients with First ST-Elevation Myocardial Infarction and to identify the cutoff value of N Terminal-Pro Brain Natriuretic Peptide (NT-proBNP) for diagnosis of multi-vessel disease. Methodology: A descriptive cross-sectional study was conducted in the Department of Cardiology at a tertiary care hospital from September 2021 to February 2022. The study included 150 patients who presented to the emergency room with first ST-elevation myocardial infarction and preserved ejection fraction. NT-proBNP levels were tested within 12 hours of hospital admission. The severity of coronary artery disease was assessed by the number of vessels affected labeled, the luminal diameter narrowing and the syntax score. Results: The mean age of participants was 60.60±11.1 years. 76% were men, 53.3% of the participants had hypertension, 44% had type 2 diabetes, and 14% were smokers. The mean BMI of the patients was 27.86±3.86. The mean ejection fraction of the patients was 50±4.5.Single-vessel disease was present in 47 (31%) and 103 (69%) had multi-vessel disease. The mean NT-proBNP level in single-vessel disease was 561.34 pg/mL, and in multi-vessel disease, it was 1640.65 pg/mL. Raised levels of NT-proBNP were significantly associated with the severity of coronary artery disease. (P-value <0.05). The optimal cut-off value of NTpro-BNP for ruling out multiple vessel disease was 947.50 pg/mL at 81% of sensitivity.Conclusion: Pro-BNP is a valuable biomarker in assessing the severity of coronary artery disease in STEMI patients. Its levels have been shown to correlate with the degree of CAD severity including multi-vessel involvement.

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In-hospital mortality is associated with high NT-proBNP level

Cited by 10 publications

References 41 publications

Natriuretic peptide level at heart failure diagnosis and risk of hospitalisation and death in England 2004–2018

Natriuretic peptide level at heart failure diagnosis and risk of hospitalisation and death in England 2004–2018

Risk factors for hospital outcomes in pulmonary embolism: A retrospective cohort study

Frequency of multi-vessel disease and its association with N Terminal-Pro Brain Natriuretic Peptide Levels among patients with First ST-Elevation Myocardial Infarction.

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