scholarly journals Predictive value for death and rehospitalization of 30-day postdischarge B-type natriuretic peptide (BNP) in elderly patients with heart failure. Sub-analysis of Italian RED Study

2015 ◽  
Vol 53 (3) ◽  
Author(s):  
Salvatore Di Somma ◽  
Rossella Marino ◽  
Giorgio Zampini ◽  
Laura Magrini ◽  
Enrico Ferri ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Natriuretic Peptide ◽  
Area Under The Curve ◽  
Signs And Symptoms ◽  
Patients With Heart Failure ◽  
Prognostic Utility ◽  
Future Events ◽  
Predictive Role

AbstractOur aim was to determine if, in elderly heart failure (eHF) patients, serial B-type natriuretic peptide (BNP) assessments obtained during follow-up after hospital discharge could have prognostic utility for death and rehospitalizations. In eHF patients, BNP assessment at hospital discharge has been demonstrated to have a high prognostic value; however, its predictive role for future cardiovascular events in eHF patients, when assessed in the period after discharge, both for the correct timing and cut-off levels, has not been completely elucidated.This study is a monocentric subanalysis of the Italian RED (Rapid Emergency Department) study. We studied 180 consecutive patients admitted for acute HF through serial BNP assessments: at hospital arrival; at discharge; and at 30, 90, and 180 days follow-up outpatient visit.Both a BNP >400 pg/mL at 30 days after discharge and the percentage variation of BNP from discharge to 30 days (Δ%BNP), compared with a BNP at discharge >400 pg/mL, showed a higher area under the curve (AUC) and odds ratio (OR) in predicting events [AUC=0.842, p<0.0001; OR 7.9 (3.3–19.0), p<0.001 for 30 days BNP and AUC=0.851, p<0.0001; OR 9.5 (4.065–22.572), p<0.0001 for Δ%BNP compared with AUC=0.638, p<0.002; OR 2.4 (1.1–5.3), p=0.032 for BNP at discharge].In patients at a high risk for future events, BNP levels assessed 30 days after hospital discharge in the absence of signs and symptoms could be predictive of subsequent hospitalization and death. These patients should be considered for closer monitoring and treatment adjustment.

Abstract 12849: Changes in N-terminal Pro Brain Natriuretic Peptide Levels Predicts Mortality and Heart Failure Hospitalization in Patients With Heart Failure and Preserved Ejection Fraction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Gianluigi Savarese ◽  
Camilla Hage ◽  
Ulf Dahlström ◽  
Pasquale Perrone-Filardi ◽  
Lars H Lund
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Total Mortality ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Impact

Introduction: Changes in N-terminal pro brain natriuretic peptide (NT-proBNP) have been demonstrated to correlate with outcomes in patients with heart failure (HF) and reduced ejection fraction (EF). However the prognostic value of a change in NT-proBNP in patients with heart failure and preserved ejection fraction (HFPEF) is unknown. Hypothesis: To assess the impact of changes in NT-proBNP on all-cause mortality, HF hospitalization and their composite in an unselected population of patients with HFPEF. Methods: 643 outpatients (age 72+12 years; 41% females) with HFPEF (ejection fraction ≥40%) enrolled in the Swedish Heart Failure Registry between 2005 and 2012 and reporting NT-proBNP levels assessment at initial registration and at follow-up were prospectively studied. Patients were divided into 2 groups according the median value of NT-proBNP absolute change that was 0 pg/ml. Median follow-up from first measurement was 2.25 years (IQR: 1.43 to 3.81). Adjusted Cox’s regression models were performed using total mortality, HF hospitalization (with censoring at death) and their composite as outcomes. Results: After adjustments for 19 baseline variables including baseline NT-proBNP, as compared with an increase in NT-proBNP levels at 6 months (NT-proBNP change>0 pg/ml), a reduction in NT-proBNP levels (NT-proBNP change<0 pg/ml) was associated with a 45.2% reduction in risk of all-cause death (HR: 0.548; 95% CI: 0.378 to 0.796; p:0.002), a 50.1% reduction in risk of HF hospitalization (HR: 0.49; 95% CI: 0.362 to 0.689; p<0.001) and a 42.6% reduction in risk of the composite outcome (HR: 0.574; 95% CI: 0.435 to 0.758; p<0.001)(Figure). Conclusions: Reductions in NT-proBNP levels over time are independently associated with an improved prognosis in HFPEF patients. Changes in NT-proBNP could represent a surrogate outcome in phase 2 HFPEF trials.

Low prevalence of B-type natriuretic peptide levels <100 pg/mL in patients with heart failure at hospital discharge

2006 ◽  
Vol 151 (5) ◽  
pp. 1012.e1-1012.e5 ◽  
Author(s):  
Jochem Hogenhuis ◽  
Adriaan A. Voors ◽  
Tiny Jaarsma ◽  
Hans L. Hillege ◽  
Arno W. Hoes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Natriuretic Peptide ◽  
Patients With Heart Failure ◽  
Low Prevalence

scholarly journals Evolution of self-care in patients with heart failure at the first outpatient return and three months after hospital discharge

2021 ◽  
Vol 29 ◽  
Author(s):  
Debora Cristine Previde Teixeira da Cunha ◽  
Lidia Aparecida Rossi ◽  
Carina Aparecida Marosti Dessote ◽  
Fabiana Bolela ◽  
Rosana Aparecida Spadoti Dantas
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Self Care ◽  
Decompensated Heart Failure ◽  
Public Hospitals ◽  
Significance Level ◽  
Brazilian Version ◽  
Patients With Heart Failure ◽  
Student’S T

Objective: to analyze the evolution of self-care in hospitalized patients with decompensated heart failure, between the first return after hospital discharge (T0) and three months after this assessment (T1). Method: an observational, analytical and longitudinal study carried out in the cardiology outpatient clinics of two public hospitals in Ribeirão Preto, São Paulo. The sociodemographic and clinical data were collected through interviews and consultation of medical records. Self-care was assessed using the Brazilian version of the Self-Care of Heart Failure Index-SCHFI instrument. The data were analyzed by means of the Student’s t test and paired distribution (McNemar) with a significance level of 0.05. Results: we verified an increase in the mean scores of the three subscales of SCHFI (Maintenance, Management and Confidence), when comparing the values of T0 and T1, these differences being statistically significant (p<0.001). When comparing the positive changes in self-care actions over these months, we found statistically significant changes in the Maintenance (6 out of 10 items), Management (5 out of 6 items) and Confidence (4 out of 6 items) subscales. Conclusion: self-care for heart failure improved in the period between the first return after discharge and the end of three months of follow-up. Further studies are needed to verify the variables associated with improved self-care after hospitalization.

scholarly journals Liver Stiffness for Predicting Adverse Cardiac Events in Chinese Patients With Heart Failure: A Two-year Prospective Study

2021 ◽  
Author(s):  
Qian Wang ◽  
Yuqing Song ◽  
Qiming Wu ◽  
Qian Dong ◽  
Song Yang
Keyword(s):  
Heart Failure ◽  
Platelet Count ◽  
Natriuretic Peptide ◽  
Liver Stiffness ◽  
Chinese Patients ◽  
Cardiac Events ◽  
Natriuretic Peptide Level ◽  
Adverse Cardiac Events ◽  
Patients With Heart Failure

Abstract Background. To investigate whether liver stiffness (LS) can predict adverse cardiac events in Chinese patients with heart failure (HF). Methods. Total of 53 hospitalized patients with HF were enrolled and LS and tricuspid annual plane systolic excursion (TAPSE)were determined before discharge with Fibroscan® and Echocardiography. The patients were divided into two groups: High LS group(LS >6.9Kpa, n=23) and Low LS group(LS ≤6.9Kp, n=30) . Patients were followed up for 24 months at interval of 3 months. The endpoint of follow-up is death or rehospitalization for HF. Results. All patients were followed up for 24 months or until the endpoint. Patients in High LS group had lower platelet count(P=0.014), lower creatine clear rate (P=0.014), higher level of B-type natriuretic peptide at discharge(P=0.012), and lower tricuspid annual plane systolic excursion (P<0.001). During 24 months follow-up, 3(5.7%) deaths and 21(39.6%) hospitalization were observed. Patients in high LS group had a higher rate of death/rehospitalization when compared with patient in low LS group (Hazard ratio: 4.81; 95% confidence interval:1.69-13.7, P=0.003) after adjustment for age, sex, platelet count, creatine clear rate, and B-type natriuretic peptide level. Also, TAPSE≤16 can predict adverse cardiac events with HR of 6.63 (95% confidence interval:1.69-13.7, P=0.004) for age, sex, platelet count, creatine clear rate, and B-type natriuretic peptide level.Conclusion. LS and TAPSE may be considered for predicting worse outcomes for patients with heart failure.

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