Cargando…

Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome

Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS)...

Descripción completa

Detalles Bibliográficos
Autores principales: Cordero, Alberto, Martínez Rey-Rañal, Elías, Moreno, María J., Escribano, David, Moreno-Arribas, José, Quintanilla, Maria A., Zuazola, Pilar, Núñez, Julio, Bertomeu-González, Vicente
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069470/
https://www.ncbi.nlm.nih.gov/pubmed/33924437
http://dx.doi.org/10.3390/jcm10081653
_version_ 1783683244446711808
author Cordero, Alberto
Martínez Rey-Rañal, Elías
Moreno, María J.
Escribano, David
Moreno-Arribas, José
Quintanilla, Maria A.
Zuazola, Pilar
Núñez, Julio
Bertomeu-González, Vicente
author_facet Cordero, Alberto
Martínez Rey-Rañal, Elías
Moreno, María J.
Escribano, David
Moreno-Arribas, José
Quintanilla, Maria A.
Zuazola, Pilar
Núñez, Julio
Bertomeu-González, Vicente
author_sort Cordero, Alberto
collection PubMed
description Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). Results: Of the 2133 included patients, 528 (24.8%) had HF during the ACS hospitalization, and their pro-BNP levels were higher (3220 pg/mL vs. 684.2 pg/mL; p < 0.001). In-hospital mortality was 2.9%, and pro-BNP was similarly higher in these patients. Increased pro-BNP levels were correlated to increased risk of HF or death during the hospitalization. Over follow-up (median 38 months) 243 (11.7%) patients had at least one hospital readmission for HF and 151 (7.1%) had more than one. Complete revascularization had a preventive effect on HF readmission, whereas several other variables were associated with higher risk. Pro-BNP was independently associated with HF admission (sHR: 1.47) and readmission (IRR: 1.45) at any age. Significant interactions were found for the predictive value of pro-BNP in women, diabetes, renal dysfunction, STEMI and patients without troponin elevation. Conclusions: In-hospital determination of pro-BNP is an independent predictor of HF readmission after an ACS.
format Online
Article
Text
id pubmed-8069470
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-80694702021-04-26 Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome Cordero, Alberto Martínez Rey-Rañal, Elías Moreno, María J. Escribano, David Moreno-Arribas, José Quintanilla, Maria A. Zuazola, Pilar Núñez, Julio Bertomeu-González, Vicente J Clin Med Article Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). Results: Of the 2133 included patients, 528 (24.8%) had HF during the ACS hospitalization, and their pro-BNP levels were higher (3220 pg/mL vs. 684.2 pg/mL; p < 0.001). In-hospital mortality was 2.9%, and pro-BNP was similarly higher in these patients. Increased pro-BNP levels were correlated to increased risk of HF or death during the hospitalization. Over follow-up (median 38 months) 243 (11.7%) patients had at least one hospital readmission for HF and 151 (7.1%) had more than one. Complete revascularization had a preventive effect on HF readmission, whereas several other variables were associated with higher risk. Pro-BNP was independently associated with HF admission (sHR: 1.47) and readmission (IRR: 1.45) at any age. Significant interactions were found for the predictive value of pro-BNP in women, diabetes, renal dysfunction, STEMI and patients without troponin elevation. Conclusions: In-hospital determination of pro-BNP is an independent predictor of HF readmission after an ACS. MDPI 2021-04-13 /pmc/articles/PMC8069470/ /pubmed/33924437 http://dx.doi.org/10.3390/jcm10081653 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cordero, Alberto
Martínez Rey-Rañal, Elías
Moreno, María J.
Escribano, David
Moreno-Arribas, José
Quintanilla, Maria A.
Zuazola, Pilar
Núñez, Julio
Bertomeu-González, Vicente
Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
title Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
title_full Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
title_fullStr Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
title_full_unstemmed Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
title_short Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
title_sort predictive value of pro-bnp for heart failure readmission after an acute coronary syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069470/
https://www.ncbi.nlm.nih.gov/pubmed/33924437
http://dx.doi.org/10.3390/jcm10081653
work_keys_str_mv AT corderoalberto predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT martinezreyranalelias predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT morenomariaj predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT escribanodavid predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT morenoarribasjose predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT quintanillamariaa predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT zuazolapilar predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT nunezjulio predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome
AT bertomeugonzalezvicente predictivevalueofprobnpforheartfailurereadmissionafteranacutecoronarysyndrome