GW24-e1414 Comparative evaluation of copeptin and NT-proBNP in Patients with severe Acute Decompensated Heart Failure Prediction of adverse events in 90-day

Heart failure (HF) is a pandemic syndrome characterised by raised morbidity and mortality. An acute HF event requiring hospitalisation is associated with a poor prognosis, in both the short and the long term. Moreover, early rehospitalisation after discharge negatively affects HF management and survival rates. Cardiovascular and non-cardiovascular conditions combine to increase rates of HF hospital readmission at 30 days. A tailored approach for HF pharmacotherapy while the patient is in hospital and immediately after discharge could be useful in reducing early adverse events that cause rehospitalisation and, consequently, prevent worsening HF and readmission during the vulnerable phase after discharge.

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High Extracellular Water Is Associated With the Adverse Events in Acute Decompensated Heart Failure (ADHF)

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2016.07.392 ◽

2016 ◽

Vol 22 (9) ◽

pp. S227

Author(s):

Yoshiyuki Yazaki ◽

Hiroki Niikura ◽

Tsuyoshi Ono ◽

Raisuke Iijima ◽

Hidehiko Hara ◽

...

Keyword(s):

Heart Failure ◽

Adverse Events ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Extracellular Water

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Superiority of proatrial natriuretic peptide in the prognostic power in patients with acute decompensated heart failure on hospital admission: comparison with B-type natriuretic peptide and other natriuretic peptide forms

Open Heart ◽

10.1136/openhrt-2019-001072 ◽

2019 ◽

Vol 6 (2) ◽

pp. e001072

Author(s):

Seiji Takashio ◽

Hiroyuki Takahama ◽

Toshio Nishikimi ◽

Tomohiro Hayashi ◽

Chiaki Nagai-Okatani ◽

...

Keyword(s):

Heart Failure ◽

Adverse Events ◽

Hospital Admission ◽

Natriuretic Peptide ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Left Ventricular ◽

Molecular Forms ◽

Lv Function ◽

Prognostic Power

AimsThere are significant differences in how atrial (A-type) and B-type natriuretic peptide (ANP and BNP) are secreted and metabolised, but there is little information available about the relative clinical significance of the two peptides. The aim of the present study was to investigate: (1) the association between the circulating level of each ANP molecular form and patient clinical background and (2) their prognostic power for patients with acute decompensated heart failure (ADHF).MethodsWe used specific chemiluminescence enzyme immunoassays to prospectively evaluate the levels of six bioactive molecular forms of ANP (pro-ANP, β-ANP and total ANP) and BNP (pro-BNP, N-terminal pro-BNP (NT-pro-BNP) and total BNP) in plasma samples collected from 173 patients with ADHF on their hospital admission.ResultsWe found that pro-ANP levels were strongly associated with left ventricular (LV) size and ejection fraction (p<0.001), but were not associated with left atrial size. Percent pro-ANP ([pro-ANP/total ANP]x100) was also associated with LV size and function. During the follow-up term (median: 469 days), composite adverse events (all causes of death or rehospitalisation for HF) occurred in 67 patients (38.7 %). Pro-ANP was significantly associated with composite adverse events even after adjusting by estimated glomerular filtration rate (eGFR) (p<0.05). In contrast, NT-pro-BNP was not independent of eGFR in the multivariate analysis.ConclusionCirculating levels of pro-ANP are strongly associated with LV function and clinical outcomes of patients with ADHF. These findings suggest that during the acute phases of HF, pro-ANP has a prognostic power comparable with NT-pro-BNP independently of renal function.

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Elevated Plasma Big Endothelin-1 at Admission Is Associated With Poor Short-Term Outcomes in Patients With Acute Decompensated Heart Failure

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.629268 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ran Mo ◽

Yan-min Yang ◽

Li-tian Yu ◽

Hui-qiong Tan ◽

Jun Zhu

Keyword(s):

Heart Failure ◽

Logistic Regression ◽

Adverse Events ◽

Predictive Power ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Short Term ◽

Endothelin 1 ◽

Net Reclassification Improvement ◽

Increased Risk

Objective: We aimed to evaluate the association between plasma big endothelin-1 (ET-1) at admission and short-term outcomes in acute decompensated heart failure (ADHF) patients.Methods: In this single-center, retrospective study, a total of 746 ADHF patients were enrolled and divided into three groups according to baseline plasma big ET-1 levels: tertile 1 (<0.43 pmol/L, n = 250), tertile 2 (between 0.43 and 0.97 pmol/L, n = 252), and tertile 3 (>0.97 pmol/L, n = 244). The primary outcomes were all-cause death, cardiac arrest, or utilization of mechanical support devices during hospitalization. Logistic regression analysis and net reclassification improvement approach were applied to assess the predictive power of big ET-1 on short-term outcomes.Results: During hospitalization, 92 (12.3%) adverse events occurred. Etiology, arterial pH, lactic acid, total bilirubin, serum creatine, serum uric acid, presence of atrial fibrillation and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were positively correlated with plasma big ET-1 level, whereas systolic blood pressure, serum sodium, hemoglobin, albumin, and estimated glomerular filtration rate were negatively correlated. In multivariate logistic regression, tertile 3 compared with tertile 1 had a 3.68-fold increased risk of adverse outcomes [odds ratio (OR) = 3.681, 95% confidence interval (CI) 1.410–9.606, p = 0.008]. However, such adverse effect did not exist between tertile 2 and tertile 1 (OR = 0.953, 95% CI 0.314–2.986, p = 0.932). As a continuous variable, big ET-1 level was significantly associated with primary outcome (OR = 1.756, 95% CI 1.413–2.183, p < 0.001). The C statistic of baseline big ET-1 was 0.66 (95% CI 0.601–0.720, p < 0.001). Net reclassification index (NRI) analysis showed that big ET-1 provided additional predictive power when combining it to NT-proBNP (NRI = 0.593, p < 0.001).Conclusion: Elevated baseline big ET-1 is an independent predictor of short-term adverse events in ADHF patients and may provide valuable information for risk stratification.

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