Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
ISSN: 2155-9880
Adriana Tamburello, Federica Ricupati and Salvatore Novo
University of Palermo, Italy
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Background: The role of Nterminal probrain natriuretic peptide (NTproBNP) to stratify risk in patients with heart failure (HF) has been analyzed. NT-proBNP levels are increased in HF, and well correlated with ventricular wall stress and severity of HF. Aim: To assess the prognostic value of NTproBNP levels and the risk of short-term death in patients with HF. Method: We studied 235 patients with an average age of 74.123 years, with clinical and echocardiographic signs of HF. 161 patients had (heart failure in reduced ejection fraction) HFrEF (EFâ�?¤45%) while 74 patients had (heart failure with preserved ejection fraction) HFpEF (EF>45%). NTproBNP was evaluated at the hospitalization and at discharge and in 76 patients it was furthermore checked after 30 days from discharge. The median followup was eight months. Moreover, we considered different parameters that may alter basic values NT-proBNP, such as chronic renal failure, physical activities and the use of certain drugs, overcoming these thresholds. Results: NT-proBNP values are above 1100 pg/mL and are prognostically meaningful in chronic HF, and a rising pattern is predictive of impending adverse outcome. Moreover, drugs used for chronic HF (such as, vasodilators, aldosterone blockers and �?²-blockers) tend to lower values of NT-proBNP. NTproBNP at discharge gives an important prognostic index for mortality (HFrEF 28.9% deceased: CIndex 0.84 P<0.0001; HFpEF 13.6% deceased: CIndex 0.76 P=0.0004). In multivariate Cox analysis, it is the stronger and independent prognostic factor (HFrEF all Pâ�?¤0.02; HFpEF all Pâ�?¤0.03). The percentage changes stratify the risk only for mortality (Ï�?2 13.68 P=0.001) conversely, categorical risk stratification shows a prognostic role for all outcomes (all log rank P<0.0001) and provides independent prognostic information when threshold values are specific for HFrEF or HFpEF compared to titrations. Conclusions: The determination of levels of NTproBNP in patients with heart failure is important for prediction of cardiovascular events; increased levels of this biomarker indicate the severity of myocardial dysfunction and severity of chronic heart failure. High levels of NT-proBNP are related with decreasing expectation of life and worse quality of daily living.
Email: adrianatamburello@gmail.com