Prognostic value of admission B-type natriuretic peptide on outcome for patients with congestive heart failure
10.3760/cma.j.issn.0253-3758.2012.06.002
- VernacularTitle:B型利钠肽水平对慢性心力衰竭患者预后的影响
- Author:
Xin-Tao DENG
1
;
Gui-Liang SHI
;
Ru-Xing WANG
;
Jian-Xiang ZHAO
;
Jin-Guo ZHENG
;
Ying-Fang BAO
Author Information
1. 扬州大学医学院附属兴化市人民医院
- Keywords:
Heart failure,congestive;
Natriuretic peptide,brain;
Prognosis
- From:
Chinese Journal of Cardiology
2012;40(6):462-466
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the prognostic value of admission B-type natriuretic peptide (BNP) on outcome for patients with congestive heart failure (CHF).Methods Blood BNP levels,routine echocardiography and tissue Doppler image were obtained in 162 CHF patients [95 male,mean age:(71.8 ±3.7 ) years] at admission.Patients were divided into high BNP ( BNP ＞ 1500 ng/L,n =104) and low BNP (BNP≤ 1500 ng/L,n =58 ) groups.All patients were followed up for 2 years and clinical characteristics,echocardiography including Doppler image and cardiovascular events results were analyzed.Data were also compared between patients with ( n =48 ) or without ( n =107 ) cardiovascular events.Results Left ventricular ejection fractions (LVEF) was significantly lower [ (40.9 ±5.6)％ vs.(44.0 ±5.9)％,P ＜0.01 ] while the total cardiovascular events rate (49.1％ vs.21.0％,P ＜0.01 ) and cardiac mortality rate (25.5％ vs.9.0％,P＜0.01) were significantly higher in high BNP group than in low BNP group.BNP level at admission in event group was significantly higher than in event-free group [ (2875.4 ±325.7) ng/Lvs.(1136.9±298.6) ng/L,P＜0.000].BNP level was positively related to Tei-index (r=0.793,P＜0.001 ) and negatively correlated with LVEF ( r =-0.57,P ＜0.001 ).Multiple logistic regression analysis demonstrated that BNP,LVEF,Tei-index and β-blocker use were independent risk factors for cardiovascular events.The area under the ROC curve for predicting cardiovascular death within 2 years in event group by BNP was 0.795 (95％ CI 0.693 - 0.935,sensitivity:72.31％ and specificity:84.62％,cut-off BNP value:1910 ng/L).The event risk was 2.17 times higher in CHF patients with admission BNP ＞ 1910 ng/Lcompared CHF patients with admission BNP ≤ 1910 ng/L ( 95％ CI:1.852 - 2.954,P =0.000 ).Conclusion Admission BNP level,LVEF,Tei-index and β-blocker use are independent risk factors for cardiovascular events in patients with CHF.Patients with higher admission BNP level ( ＞ 1910 ng/L) is linked with worse prognosis in this patient cohort.
