BACKGROUND: Obesity may reduce diagnostic accuracy of B-type natriuretic peptide (BNP) and affect long-term outcome. METHODS: This study evaluated patients included in the BASEL study (N = 452). We compared BNP levels in patients with (n = 86) and without (n = 366) obesity (body mass index <30 and >30 kg/m(2)) and determinedsensitivities and specificities of BNP in both patient groups by receiver-operating characteristic analysis. Impact of BNP measurements on patient management and outcome in obesity, as well as 360-day mortality, was assessed. RESULTS: The BNP levels were lower in obese patients (172 pg/mL [interquartile range 31-515] vs 306 [interquartile range 75-1,040]). The optimal BNP cut-point to detect heart failure was 182 pg/mL in obese patients and 298 pg/mL nonobese patients. Obese patients had lower in-hospital mortality (3.5% vs 8.5%, P = .045) and 360-day mortality (15% vs 30%, P = .001). In obese patients, the determination of BNP levels reduced time to initiation of the appropriate treatment (96 +/- 98 vs 176 +/- 230, P < .05) without impacting other end points. CONCLUSIONS: Adjustment of BNP values in the assessment of obese patients presenting with acute dyspnea seems necessary to improve diagnostic accuracy and patient management. Obese patients had half the short- and long-term mortality of nonobese patients, independent of their final discharge diagnosis.
RCT Entities:
BACKGROUND:Obesity may reduce diagnostic accuracy of B-type natriuretic peptide (BNP) and affect long-term outcome. METHODS: This study evaluated patients included in the BASEL study (N = 452). We compared BNP levels in patients with (n = 86) and without (n = 366) obesity (body mass index <30 and >30 kg/m(2)) and determined sensitivities and specificities of BNP in both patient groups by receiver-operating characteristic analysis. Impact of BNP measurements on patient management and outcome in obesity, as well as 360-day mortality, was assessed. RESULTS: The BNP levels were lower in obesepatients (172 pg/mL [interquartile range 31-515] vs 306 [interquartile range 75-1,040]). The optimal BNP cut-point to detect heart failure was 182 pg/mL in obesepatients and 298 pg/mL nonobese patients. Obesepatients had lower in-hospital mortality (3.5% vs 8.5%, P = .045) and 360-day mortality (15% vs 30%, P = .001). In obesepatients, the determination of BNP levels reduced time to initiation of the appropriate treatment (96 +/- 98 vs 176 +/- 230, P < .05) without impacting other end points. CONCLUSIONS: Adjustment of BNP values in the assessment of obesepatients presenting with acute dyspnea seems necessary to improve diagnostic accuracy and patient management. Obesepatients had half the short- and long-term mortality of nonobese patients, independent of their final discharge diagnosis.
Authors: Stephen A Hill; Ronald A Booth; P Lina Santaguida; Andrew Don-Wauchope; Judy A Brown; Mark Oremus; Usman Ali; Amy Bustamam; Nazmul Sohel; Robert McKelvie; Cynthia Balion; Parminder Raina Journal: Heart Fail Rev Date: 2014-08 Impact factor: 4.214
Authors: Christoph Sinning; Francisco Ojeda; Philipp S Wild; Renate B Schnabel; Michael Schwarzl; Sevenai Ohdah; Karl J Lackner; Norbert Pfeiffer; Matthias Michal; Maria Blettner; Thomas Munzel; Tibor Kempf; Kai C Wollert; Kari Kuulasmaa; Stefan Blankenberg; Veikko Salomaa; Dirk Westermann; Tanja Zeller Journal: Clin Res Cardiol Date: 2016-12-21 Impact factor: 5.460