Karakoyun Inanc, Colak Ayfer, Arslan Fatma Demet, Hasturk Aybike Gunaslan, Duman Can
Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.
Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.
Am J Emerg Med. 2017 Nov;35(11):1677-1681. doi: 10.1016/j.ajem.2017.05.048. Epub 2017 May 31.
The incidence of heart failure (HF) has reached epidemic levels in western populations, and the majority of these patients are admitted to hospitals through the emergency department (ED). We aimed to aid clinicians assessing natriuretic peptide (NP) levels in cases with suspected HF. In this study, we investigated the effect of anemia on amino-terminal pro-BNP (NT-proBNP) and on B-type natriuretic peptide (BNP) levels.
This retrospective study examined patients who were admitted to the ED with suspected HF. After admission, the treating physician requested complete blood count and creatinine tests with NT-proBNP (n=2.637) or BNP (n=11.159). The exclusion criteria were used to minimize the factors that could affect the NT-proBNP and BNP results. We examined the data using the Mann-Whitney U test, Chi-square test, Spearman correlation test, and multivariate linear regression analyses.
The NT-proBNP and BNP levels were statistically higher in the groups with anemia (p=0.016 and p=0.009, respectively). There was a statistically significant negative correlation between hemoglobin and NP levels (r=-0.272, p<0.001 for NT-proBNP and r=-0.179, p<0.001 for BNP). The results indicated that advanced age and low hemoglobin levels were significantly associated with the increase in NT-proBNP (p=0.024 and p=0.004, respectively). Advanced age, low hemoglobin and low GFR-MDRD levels were significantly associated with the increase in BNP (p<0.001, p=0.002 and p=0.013, respectively).
The data suggest that clinicians examining patients admitted to the ED with suspected HF should consider that anemia could lead to increases in NT-proBNP and BNP levels.
心力衰竭（HF）的发病率在西方人群中已达到流行程度，并且这些患者中的大多数是通过急诊科（ED）入院的。我们旨在帮助临床医生评估疑似心力衰竭病例中的利钠肽（NP）水平。在本研究中，我们调查了贫血对氨基末端脑钠肽前体（NT-proBNP）和B型利钠肽（BNP）水平的影响。
这项回顾性研究检查了因疑似心力衰竭而入住急诊科的患者。入院后，主治医生要求进行全血细胞计数以及NT-proBNP（n = 2637）或BNP（n = 11159）的肌酐检测。排除标准用于尽量减少可能影响NT-proBNP和BNP结果的因素。我们使用曼-惠特尼U检验、卡方检验、斯皮尔曼相关性检验和多元线性回归分析来检查数据。
贫血组的NT-proBNP和BNP水平在统计学上更高（分别为p = 0.016和p = 0.009）。血红蛋白与NP水平之间存在统计学上的显著负相关（NT-proBNP的r = -0.272，p < 0.001；BNP的r = -0.179，p < 0.001）。结果表明，高龄和低血红蛋白水平与NT-proBNP的升高显著相关（分别为p = 0.024和p = 0.004）。高龄、低血红蛋白和低肾小球滤过率-MDRD水平与BNP的升高显著相关（分别为p < 0.001、p = 0.002和p = 0.013）。
数据表明，检查因疑似心力衰竭入住急诊科患者的临床医生应考虑到贫血可能导致NT-proBNP和BNP水平升高。
