Improvements of predictive power of B-type natriuretic peptide on admission by mathematically estimating its discharge levels in hospitalised patients with acute heart failure

Eiji Anegawa, Hiroyuki Takahama, Kunihiro Nishimura, Daisuke Onozuka, Yuki Irie, Kenji Moriuchi, Masashi Amano, Atsushi Okada, Makoto Amaki, Hideaki Kanzaki, Teruo Noguchi, Kengo Kusano, Satoshi Yasuda, Chisato Izumi

研究成果: Article査読

抄録

Backgrounds Earlier studies showed that in patients with heart failure (HF), circulating levels of B-type natriuretic peptide (BNP) at hospital discharge (BNP dis) are more predictive of prognosis than BNP levels on admission (BNP ad). However, the mechanism underlying that difference has not been fully elucidated. We examined the association between confounding factors during hospitalisation and BNP dis in patients with HF. Methods We identified patients admitted to our hospital for HF (BNP ad ≥100 pg/mL). Estimated left ventricular end-diastolic pressure (eLVEDP) was calculated using echocardiographic data. To identify the factors associated with the relation between BNP ad and BNP dis, we performed a stepwise regression analysis of retrospective data. To validate that analysis, we performed a prospective study. Results Through stepwise regression of the patient data (n=688, New York Heart Association 3-4, 88%), we found age, blood urea nitrogen and eLVEDP to be significantly (p<0.05) associated with BNP dis. Through multivariate analysis after accounting for these factors, we created a formula for predicting BNP levels at discharge (predicted-BNP dis) from BNP ad and other parameters measured at admission (p<0.05). By statistically adjusting for these factors, the prognostic power of BNP ad was significantly improved (p<0.001). The prospective study also confirmed the strong correlation between predicted-BNP dis and BNP dis (n=104, r=0.625, p<0.05). Conclusion This study showed that statistically accounting for confounding factors affecting BNP levels improves the predictive power of BNP levels measured at the time of hospital admission, suggesting that these confounding factors are associated with lowering predictive power of BNP on admission.

本文言語English
論文番号e001603
ジャーナルOpen Heart
8
1
DOI
出版ステータスPublished - 2021 5 17
外部発表はい

ASJC Scopus subject areas

  • 循環器および心血管医学

フィンガープリント

「Improvements of predictive power of B-type natriuretic peptide on admission by mathematically estimating its discharge levels in hospitalised patients with acute heart failure」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル