+ Site Statistics
References:
52,654,530
Abstracts:
29,560,856
PMIDs:
28,072,755
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Extremely elevated BNP in acute heart failure: Patient characteristics and outcomes



Extremely elevated BNP in acute heart failure: Patient characteristics and outcomes



International Journal of Cardiology 218: 120-125



We explored the clinical characteristics and outcomes of patients with acute systolic heart failure (HF) and extremely elevated admission B-type natriuretic peptide (BNP). Extremely elevated BNP was defined if BNP level was >85th percentile of the study cohort (i.e. >1694pg/mL). Our objectives were to find characteristic features that identify patients with extremely elevated BNP, to compare the degree of congestion in both groups and to study post-discharge outcomes. 347 patients (mean age 56years, 74% males) were divided into two groups based on whether BNP was extremely elevated (n=53) or not (n=294). Those with extremely elevated BNP were older (P=0.004), with a lower body mass index (P<0.0001), higher blood urea nitrogen (P=0.01), higher creatinine (P=0.005), lower cardiac output (P<0.0001) and lower cardiac index (P=0.001). With regards to signs of congestion, both groups had no significant difference in the frequency of rales (P=0.454), peripheral edema (P=0.397), jugular venous distension (P=0.396), positive hepatojugular reflux (P=0.083), S3 gallop (P=0.107), mean pulmonary capillary wedge pressure (P=0.351), and right atrial pressure (P=0.310). Both groups had similar frequency of rehospitalization for HF (P=0.939), nonetheless, patients with extremely elevated BNP had longer hospital stay during initial (P=0.014), or subsequent hospitalization (30days: P=0.01, 180days: P=0.008). 6-month all-cause-mortality was higher in patients with extremely elevated BNP (P=0.008), although death due to pump failure was not (P=0.921). Cox proportional hazard analysis revealed that extremely elevated admission BNP is an independent predictor of 6-month all-cause-mortality (hazard ratio 1.857, 95% CI=1.074-3.208, P=0.027) after adjustment for known predictors of post-discharge mortality in HF. Extremely elevated admission BNP did not match the degree of congestion nor was a predictor of rehospitalization due to HF. It was associated with decreased COP, prolonged hospital stay, and increased 6-month all-cause-mortality.

(PDF emailed within 0-6 h: $19.90)

Accession: 057851040

Download citation: RISBibTeXText

PMID: 27232923

DOI: 10.1016/j.ijcard.2016.05.038


Related references

Patient characteristics and outcomes associated with nitrovasodilator use in the treatment of acute heart failure. American Journal of Therapeutics 22(3): 206-213, 2016

Rise in BNP despite appropriate acute decompensated heart failure treatment : Patient characteristics and outcomes. Herz 42(4): 411-417, 2016

Demographics, Clinical Characteristics, Management, and Outcomes of Acute Heart Failure Patients: Observations from the Oman Acute Heart Failure Registry. Oman Medical Journal 31(3): 188-195, 2016

Clinical characteristics and outcomes of Yemeni patients with acute heart failure aged 50years or younger: Data from Gulf Acute Heart Failure Registry (Gulf CARE). International Journal of Cardiology 229: 91-95, 2016

Characteristics, outcomes and predictors of long-term mortality for patients hospitalized for acute heart failure: a report from the korean heart failure registry. Korean Circulation Journal 41(7): 363-371, 2011

Clinical characteristics, management, and outcomes of acute heart failure patients: observations from the Gulf acute heart failure registry (Gulf CARE). European Journal of Heart Failure 17(4): 374-384, 2016

Temporal trends in clinical characteristics, treatments, and outcomes for heart failure hospitalizations, 2002 to 2004: findings from Acute Decompensated Heart Failure National Registry (ADHERE). American Heart Journal 153(6): 1021-1028, 2007

eGFR and Outcomes in Patients with Acute Decompensated Heart Failure with or without Elevated BUN. Clinical Journal of the American Society of Nephrology 11(3): 405-412, 2016

Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). American Heart Journal 149(2): 209-216, 2005

Frequency, patient characteristics, and outcomes of mild-to-moderate heart failure complicating ST-segment elevation acute myocardial infarction: lessons from 4 international fibrinolytic therapy trials. American Heart Journal 145(1): 73-79, 2003

Frequency, patient characteristics, and outcomes of mild to moderate heart failure complicating ST-segment elevation acute myocardial infarction Lessons from four international fibrinolytic therapy trials. Circulation 104(17 Supplement): II 483, October 23, 2001

Early intravenous heart failure therapy and outcomes among older patients hospitalized for acute decompensated heart failure: findings from the Acute Decompensated Heart Failure Registry Emergency Module (ADHERE-EM). American Heart Journal 166(2): 349-356, 2013

Hypertensive heart failure: patient characteristics, treatment, and outcomes. American Journal of Emergency Medicine 29(8): 855-862, 2011

Increased 90-day mortality in patients with acute heart failure with elevated copeptin: secondary results from the Biomarkers in Acute Heart Failure (BACH) study. Circulation. Heart Failure 4(5): 613-620, 2011