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[B型利钠肽原N端部分绝对下降值在失代偿性心力衰竭中的预后价值:CLUSTER-HF研究的二次分析]

[Prognostic value of the absolute decrease of the N-terminal portion of B-type natriuretic propeptide in decompensated heart failure: secondary analysis of the CLUSTER-HF study].

作者信息

Paredes-Paucar Cynthia, Medina Leonardo Villa, Araiza-Garaygordobil Diego, Gopar-Nieto Rodrigo, Martínez-Amezcua Pablo, Cabello-Lopez Alejandro, Sierra-Lara Daniel, Briseño De La Cruz José Luis, Gonzáles Pacheco Hector, Arias Mendoza Alexandra

机构信息

Instituto Nacional Cardiovascular. Lima, Perú Instituto Nacional Cardiovascular Lima Perú.

Hospital Alberto Sabogal Sologuren. Callao, Perú Hospital Alberto Sabogal Sologuren Callao Perú.

出版信息

Arch Peru Cardiol Cir Cardiovasc. 2022 Mar 31;3(1):8-15. doi: 10.47487/apcyccv.v3i1.198. eCollection 2022 Jan-Mar.

Abstract

OBJECTIVE

The purpose of this study is to determine the prognostic value of the absolute decrease in the N-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) to prevent fewer clinical events, in the population of CLUSTER-HF (efficacy of ultrasound lung to guide therapy and prevent readmissions in heart failure).

MATERIALS AND METHODS

This study was conducted in a subgroup of ninety-four patients with available NT-proBNP information at hospital discharge and prior to randomization in the CLUSTER-HF study. The primary objective of the study was to determine the prognostic value of absolute NT-proBNP decline below which fewer events of all-cause death, emergency room visits, and rehospitalization for heart failure at 180 days.

RESULTS

The absolute decrease in NT-proBNP below 3,350 pg/mL has a moderate discriminative capacity with AUC= 0.602, with a prognostic value in the combined event at 180 days (log-rank test, p=0.01). Also, according to the multivariable analysis, it is an independent marker of clinical events at 180 days OR 0.319 (0.102-0.995, p=0.04) above other clinical variables.

CONCLUSIONS

An absolute decrease to 3,350 pg/mL of NT-proBNP or less at discharge from the hospitalization due to heart failure, was associated with fewer clinical events at 180 days.

摘要

目的

本研究旨在确定在CLUSTER-HF(超声引导治疗及预防心力衰竭再入院的疗效)研究人群中,B型利钠肽原N端(NT-proBNP)的绝对下降值对预防较少临床事件的预后价值。

材料与方法

本研究在CLUSTER-HF研究中94例出院时及随机分组前有可用NT-proBNP信息的患者亚组中进行。该研究的主要目的是确定NT-proBNP绝对下降的预后价值,低于此值时,180天时全因死亡、急诊就诊及因心力衰竭再次住院的事件较少。

结果

NT-proBNP绝对下降至低于3350 pg/mL具有中等鉴别能力,曲线下面积(AUC)=0.602,对180天时的联合事件具有预后价值(对数秩检验,p=0.01)。此外,根据多变量分析,与其他临床变量相比,它是180天时临床事件的独立标志物,比值比(OR)为0.319(0.102-0.995,p=0.04)。

结论

因心力衰竭住院出院时NT-proBNP绝对下降至3350 pg/mL或更低,与180天时较少的临床事件相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8648/10318989/7e093fd8bf76/apcyccv-3-08-g001.jpg

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