Post-discharge changes in NT-proBNP and quality of life after acute dyspnea hospitalization as predictors of one-year outcomes.

Abstract

AIMS:

The association of serial NT-proBNP changes and poor quality of life (QOL) with progressive heart failure (HF) and clinical outcomes in emergency department dyspnea patients is poorly understood.

METHODS AND RESULTS:

The predictive value of changes in NT-proBNP and QOL (Minnesota Living with Heart Failure scale) from baseline to 30-day follow-up was examined for all-cause 1-year mortality and HF hospitalization. Patients with an initially elevated NT-proBNP (≥300 ng/L) which persisted at 30-days (no ≥25% decrease) were at high risk of death or HF hospitalization (HR=6.36, 95%CI=3.04-13.28). Combined with sustained poor QOL, these subjects with persistently elevated NT-proBNP were at highest mortality risk or HF hospitalization (HR=8.75, 95%CI=3.62-21.16).

CONCLUSIONS:

Dyspnea patients with elevated NT-proBNP concentrations and no improvement in either NT-proBNP or QOL at 30-days are at high risk of mortality and HF hospitalization. These data highlight the value of serial biomarker measurements combined with serial evaluations for QOL.

• Authors: Keyur B Shah, Willem J Kop, Robert H Christenson, Deborah B Diercks, Dick Kuo, Sue Henderson, Karen Hanson, Christopher R deFilippi
• Journal: Clinical biochemistry (Clin Biochem) Vol. 43 Issue 18 Pg. 1405-10 (Dec 2010) ISSN: 1873-2933 [Electronic] United States
• PMID: 20850426 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Adult
• Aged
• Biomarkers (blood)
• Cohort Studies
• Dyspnea (blood, etiology, therapy)
• Heart Failure (complications, mortality)
• Hospitalization
• Humans
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Patient Discharge
• Peptide Fragments (blood)
• Predictive Value of Tests
• Prospective Studies
• Quality of Life
• Surveys and Questionnaires
• Treatment Outcome