Prognostic value of N-Terminal Pro-B-Type Natriuretic Peptide in Takotsubo syndrome View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-04-19

AUTHORS

Thomas Stiermaier, Francesco Santoro, Tobias Graf, Francesca Guastafierro, Nicola Tarantino, Luisa De Gennaro, Pasquale Caldarola, Matteo Di Biase, Holger Thiele, Natale D. Brunetti, Christian Möller, Ingo Eitel

ABSTRACT

BackgroundTakotsubo syndrome (TTS), a form of acute transient heart failure, has been associated with severe complications and considerable mortality rates. N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) might serve as a marker to identify high-risk patients but has not yet been investigated regarding prognostic implications in TTS. Aim of this study was to determine the short- and long-term prognostic utility of NT-proBNP in patients with TTS.MethodsThe predictive value of admission NT-proBNP was assessed in an international, multicenter study including 177 consecutive TTS patients. Predefined endpoints were 30-day major adverse cardiac events (MACE) consisting of all-cause death, cardiogenic shock, and pulmonary edema as well as long-term mortality in median 2.3 years after the acute event.ResultsStratification according to median admission NT-proBNP (4511 pg/ml) resulted in significantly higher 30-day MACE [22.5 versus 9.1%; odds ratio (OR) 2.90, 95% confidence interval (CI) 1.20–6.99 p = 0.015] and long-term mortality rates [16.3 versus 9.4%; hazard ratio (HR) 2.72, 95% CI 1.13–6.56 p = 0.021] in patients > median. The best admission NT-proBNP cutoffs to predict 30-day MACE and long-term mortality were determined at 5560 and 8178 pg/ml respectively, with subsequent improved risk stratification for short-term MACE (OR 3.61, 95% CI 1.49–8.72; p = 0.003) and long-term mortality (HR 4.40; 95% CI 1.85–10.44, p < 0.001). Multivariate regression analysis identified admission NT-proBNP as an independent predictor of 30-day MACE (p < 0.001) and long-term mortality (p = 0.012).ConclusionsAdmission NT-proBNP is an independent predictor for short- and long-term adverse events in TTS patients and, therefore, a useful marker for risk stratification immediately at presentation. More... »

PAGES

597-606

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-018-1227-1

DOI

http://dx.doi.org/10.1007/s00392-018-1227-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1103464619

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29675571


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29 schema:description BackgroundTakotsubo syndrome (TTS), a form of acute transient heart failure, has been associated with severe complications and considerable mortality rates. N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) might serve as a marker to identify high-risk patients but has not yet been investigated regarding prognostic implications in TTS. Aim of this study was to determine the short- and long-term prognostic utility of NT-proBNP in patients with TTS.MethodsThe predictive value of admission NT-proBNP was assessed in an international, multicenter study including 177 consecutive TTS patients. Predefined endpoints were 30-day major adverse cardiac events (MACE) consisting of all-cause death, cardiogenic shock, and pulmonary edema as well as long-term mortality in median 2.3 years after the acute event.ResultsStratification according to median admission NT-proBNP (4511 pg/ml) resulted in significantly higher 30-day MACE [22.5 versus 9.1%; odds ratio (OR) 2.90, 95% confidence interval (CI) 1.20–6.99 p = 0.015] and long-term mortality rates [16.3 versus 9.4%; hazard ratio (HR) 2.72, 95% CI 1.13–6.56 p = 0.021] in patients > median. The best admission NT-proBNP cutoffs to predict 30-day MACE and long-term mortality were determined at 5560 and 8178 pg/ml respectively, with subsequent improved risk stratification for short-term MACE (OR 3.61, 95% CI 1.49–8.72; p = 0.003) and long-term mortality (HR 4.40; 95% CI 1.85–10.44, p < 0.001). Multivariate regression analysis identified admission NT-proBNP as an independent predictor of 30-day MACE (p < 0.001) and long-term mortality (p = 0.012).ConclusionsAdmission NT-proBNP is an independent predictor for short- and long-term adverse events in TTS patients and, therefore, a useful marker for risk stratification immediately at presentation.
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35 schema:keywords MethodsThe predictive value
36 N-terminal pro-B-type natriuretic peptide
37 NT-proBNP
38 Predefined endpoints
39 TTS
40 TTS patients
41 Takotsubo syndrome
42 acute event
43 admission NT-proBNP
44 adverse cardiac events
45 adverse events
46 analysis
47 cardiac events
48 cardiogenic shock
49 cause death
50 complications
51 consecutive TTS patients
52 considerable mortality rate
53 cutoff
54 death
55 edema
56 endpoint
57 events
58 failure
59 form
60 heart failure
61 high-risk patients
62 implications
63 improved risk stratification
64 independent predictors
65 long-term adverse events
66 long-term mortality
67 long-term mortality rates
68 long-term prognostic utility
69 major adverse cardiac events
70 markers
71 median
72 mortality
73 mortality rate
74 multicenter study
75 multivariate regression analysis
76 natriuretic peptide
77 patients
78 peptides
79 pg/
80 predictive value
81 predictors
82 presentation
83 pro-B-type natriuretic peptide
84 prognostic implications
85 prognostic utility
86 prognostic value
87 pulmonary edema
88 rate
89 regression analysis
90 risk stratification
91 severe complications
92 shock
93 stratification
94 study
95 syndrome
96 transient heart failure
97 useful marker
98 utility
99 values
100 years
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