PMID- 27635179
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160916
LR  - 20201001
IS  - 1918-3003 (Print)
IS  - 1918-3011 (Electronic)
IS  - 1918-3003 (Linking)
VI  - 8
IP  - 10
DP  - 2016 Oct
TI  - Change of Serum BNP Between Admission and Discharge After Acute Decompensated 
      Heart Failure Is a Better Predictor of 6-Month All-Cause Mortality Than the 
      Single BNP Value Determined at Admission.
PG  - 737-42
LID - 10.14740/jocmr2691w [doi]
AB  - BACKGROUND: B-type natriuretic peptide (BNP) is regarded as a reliable predictor 
      of outcome in patients with acute decompensated heart failure (ADHF). However, 
      according to some scholars, a single isolated measurement of serum BNP at the 
      time of hospital admission would not be sufficient to provide reliable prognostic 
      information. METHODS: A retrospective study was carried out on patients 
      hospitalized for ADHF, who had then undergone follow-up of at least 6 months, in 
      order to see if there was any difference in midterm mortality among patients with 
      rising BNP at discharge as compared to those with decreasing BNP at discharge. 
      Medical records had to be carefully examined to divide the case records into two 
      groups, the former characterized by an increase in BNP during hospitalization, 
      and the latter showing a decrease in BNP from the time of admission to the time 
      of discharge. RESULTS: Ultimately, 177 patients were enrolled in a retrospective 
      study. Among them, 53 patients (29.94%) had increased BNPs at the time of 
      discharge relative to admission, whereas 124 (70.06%) exhibited decreases in 
      serum BNP during their hospital stay. The group with patients who exhibited BNP 
      increases at the time of discharge had higher degree of congestion evident in the 
      higher frequency of persistent jugular venous distention (odds ratio: 3.72; P = 
      0.0001) and persistent orthopnea at discharge (odds ratio: 2.93; P = 0.0016). 
      Moreover, patients with increased BNP at the time of discharge had a lower 
      reduction in inferior vena cava maximum diameter (1.58 +/- 2.2 mm vs. 6.32 +/- 1.82 
      mm; P = 0.001 (one-way ANOVA)). In contrast, there was no significant difference 
      in weight loss when patients with increased BNP at discharge were compared to 
      those with no such increase. A total of 14 patients (7.9%) died during the 
      6-month follow-up period. Cox proportional hazard analysis revealed that BNP 
      increase at the time of discharge was an independent predictor of 6-month 
      all-cause mortality after adjustment for age, sodium at discharge, creatinine at 
      discharge and New York Heart Association (NYHA) class at discharge (hazard ratio 
      34.49; 95% confidence intervals: 4.55 - 261.06; P = 0.001). CONCLUSIONS: Among 
      patients with recent ADHF, increased BNP at the time of discharge from the 
      hospital entailed a higher grade of congestion and higher 6-month mortality.
FAU - De Vecchis, Renato
AU  - De Vecchis R
AD  - Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 
      Centro, Napoli, Italy.
FAU - Ariano, Carmelina
AU  - Ariano C
AD  - Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 
      Centro, Napoli, Italy; Division of Cardiology, Casa di Cura "Sollievo della 
      Sofferenza", S. Giovanni Rotondo, Italy.
FAU - Giandomenico, Giuseppe
AU  - Giandomenico G
AD  - Hospital Directorate, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 
      Centro, Napoli, Italy.
FAU - Di Maio, Marco
AU  - Di Maio M
AD  - Department of Cardiology, Second University of Napoli, Monaldi Hospital, Napoli, 
      Italy.
FAU - Baldi, Cesare
AU  - Baldi C
AD  - Heart Department, Interventional Cardiology, A.O.U. "San Giovanni di Dio e Ruggi 
      d'Aragona", Salerno, Italy.
LA  - eng
PT  - Journal Article
DEP - 20160830
PL  - Canada
TA  - J Clin Med Res
JT  - Journal of clinical medicine research
JID - 101538301
PMC - PMC5012243
OTO - NOTNLM
OT  - B-type natriuretic peptide
OT  - Congestion
OT  - Heart failure
EDAT- 2016/09/17 06:00
MHDA- 2016/09/17 06:01
PMCR- 2016/08/30
CRDT- 2016/09/17 06:00
PHST- 2016/08/17 00:00 [accepted]
PHST- 2016/09/17 06:00 [entrez]
PHST- 2016/09/17 06:00 [pubmed]
PHST- 2016/09/17 06:01 [medline]
PHST- 2016/08/30 00:00 [pmc-release]
AID - 10.14740/jocmr2691w [doi]
PST - ppublish
SO  - J Clin Med Res. 2016 Oct;8(10):737-42. doi: 10.14740/jocmr2691w. Epub 2016 Aug 
      30.