BACKGROUND: The prognostic value of NT-proBNP levels in patients admitted to hospital due to acute exacerbations of chronic pulmonary diseases (CPDs) is unknown. SETTING: Internal Medicine units at two general hospitals. METHODS: NT-proBNP levels were obtained within 72 h after admission in 192 consecutive patients with acute exacerbations of CPDs and no history of heart failure or diuretic treatment. Clinical characteristics and main outcomes were assessed over a 12-month follow-up. NT-proBNP cut-points for outcomes were obtained by ROC (receiver operating characteristics) curve analysis. RESULTS: Chronic obstructive lung disease (69.3%) and chronic asthma (22.4%) were the most prevalent CPDs, and non-pneumonic acute respiratory infection (72.4%) and pneumonia (22.9%) were the most frequent causes of exacerbation. Atrial flutter or fibrillation rate was 11%. During the one-year follow-up period, 22 patients died, 42 were re-admitted, 46 received new long-term oxygen therapy, and 39 received new diuretic treatment. NT-proBNP values correlated with hospitalisation days. NT-proBNP values over 587.9 pg/ml were associated with significantly raised one-year mortality (OR=3.90; 95% IC 1.46-10.47; p=0.006) and over 782.2 pg/ml with cardio-pulmonary deaths (OR=6.38; 95% IC 1.91-21.3; p=0.002). That association persisted after adjustment for age, gender, creatinine levels and cardiac rhythm. NT-proBNP values over 628.7 pg/ml were associated with significantly higher probability of new diuretic treatment (OR=4.38; IC 95% 2.07-9.25; p<0.001). The negative predictive values for these cut-points ranged from 89% to 97%. CONCLUSION: NT-proBNP levels below 587.9 pg/ml in patients with acute exacerbations of CPD were associated with favourable one-year outcomes.
BACKGROUND: The prognostic value of NT-proBNP levels in patients admitted to hospital due to acute exacerbations of chronic pulmonary diseases (CPDs) is unknown. SETTING: Internal Medicine units at two general hospitals. METHODS: NT-proBNP levels were obtained within 72 h after admission in 192 consecutive patients with acute exacerbations of CPDs and no history of heart failure or diuretic treatment. Clinical characteristics and main outcomes were assessed over a 12-month follow-up. NT-proBNP cut-points for outcomes were obtained by ROC (receiver operating characteristics) curve analysis. RESULTS:Chronic obstructive lung disease (69.3%) and chronic asthma (22.4%) were the most prevalent CPDs, and non-pneumonic acute respiratory infection (72.4%) and pneumonia (22.9%) were the most frequent causes of exacerbation. Atrial flutter or fibrillation rate was 11%. During the one-year follow-up period, 22 patients died, 42 were re-admitted, 46 received new long-term oxygen therapy, and 39 received new diuretic treatment. NT-proBNP values correlated with hospitalisation days. NT-proBNP values over 587.9 pg/ml were associated with significantly raised one-year mortality (OR=3.90; 95% IC 1.46-10.47; p=0.006) and over 782.2 pg/ml with cardio-pulmonary deaths (OR=6.38; 95% IC 1.91-21.3; p=0.002). That association persisted after adjustment for age, gender, creatinine levels and cardiac rhythm. NT-proBNP values over 628.7 pg/ml were associated with significantly higher probability of new diuretic treatment (OR=4.38; IC 95% 2.07-9.25; p<0.001). The negative predictive values for these cut-points ranged from 89% to 97%. CONCLUSION: NT-proBNP levels below 587.9 pg/ml in patients with acute exacerbations of CPD were associated with favourable one-year outcomes.
Authors: Wassim W Labaki; Meng Xia; Susan Murray; Jeffrey L Curtis; R Graham Barr; Surya P Bhatt; Eugene R Bleecker; Nadia N Hansel; Christopher B Cooper; Mark T Dransfield; J Michael Wells; Eric A Hoffman; Richard E Kanner; Robert Paine; Victor E Ortega; Stephen P Peters; Jerry A Krishnan; Russell P Bowler; David J Couper; Prescott G Woodruff; Fernando J Martinez; Carlos H Martinez; MeiLan K Han Journal: Respir Med Date: 2018-06-05 Impact factor: 3.415
Authors: Arne Didrik Høiseth; Torbjørn Omland; Bo Daniel Karlsson; Pål H Brekke; Vidar Søyseth Journal: Int J Chron Obstruct Pulmon Dis Date: 2013-12-05
Authors: Susanna Price; Elke Platz; Louise Cullen; Guido Tavazzi; Michael Christ; Martin R Cowie; Alan S Maisel; Josep Masip; Oscar Miro; John J McMurray; W Frank Peacock; F Javier Martin-Sanchez; Salvatore Di Somma; Hector Bueno; Uwe Zeymer; Christian Mueller Journal: Nat Rev Cardiol Date: 2017-04-27 Impact factor: 32.419