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The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease
BACKGROUND: The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide (NT-proBNP) remains unclear in coronary artery disease (CAD). This study sought to investigate the value of using NT-proBNP level to predict prognoses of CAD patients with different estimate...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Via Medica
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083050/ https://www.ncbi.nlm.nih.gov/pubmed/29611168 http://dx.doi.org/10.5603/CJ.a2018.0031 |
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author | Chen, Fei Li, Jia-qi Ou, Yuan-Wei-Xiang Xia, Tian-li Huang, Fang-yang Chai, Hua Huang, Bao-tao Li, Qiao Pu, Xiao-bo Li, Guo-yong Peng, Yong Chen, Mao Huang, De-jia |
author_facet | Chen, Fei Li, Jia-qi Ou, Yuan-Wei-Xiang Xia, Tian-li Huang, Fang-yang Chai, Hua Huang, Bao-tao Li, Qiao Pu, Xiao-bo Li, Guo-yong Peng, Yong Chen, Mao Huang, De-jia |
author_sort | Chen, Fei |
collection | PubMed |
description | BACKGROUND: The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide (NT-proBNP) remains unclear in coronary artery disease (CAD). This study sought to investigate the value of using NT-proBNP level to predict prognoses of CAD patients with different estimated glomerular filtration rates (eGFRs). METHODS: A retrospective analysis was conducted from a single registered database. 2087 consecutive patients with CAD confirmed by coronary angiography were enrolled. The primary endpoint was allcause mortality. RESULTS: The mean follow-up time was 26.4 ± 11.9 months and death events occurred in 197 cases. The NT-proBNP levels increased with the deterioration of renal function, as well as the optimal cutoff values based on eGFR stratification to predict endpoint outcome (179.4 pg/mL, 1443.0 pg/mL, 3478.0 pg/mL, for eGFR ≥ 90, 60–90 and < 60 mL/min/1.73 m(2), respectively). Compared with the routine cut-off value or overall optimal one, stratified optimal ones had superior predictive ability for endpoint in each eGFR group (all with the highest Youden’s J statistics). And the prognostic value became weaker as eGFR level decreased (eGFR ≥ 90 vs. 60–90 vs. < 60 mL/min/1.73 m(2), odds ratio [OR] 7.7; 95% confidence interval [CI] 1.7–33.9 vs. OR 4.8; 95% CI 2.7–8.5 vs. OR 3.0; 95% CI 1.5–6.2). CONCLUSIONS: This study demonstrated that NT-proBNP exhibits different predictive values for prognosis for CAD patients with different levels of renal function. Among the assessed values, the NT-proBNP cut-off value determined using renal function improve the accuracy of the prognosis prediction of CAD. Moreover, lower eGFR is associated with a higher NT-proBNP cut-off value for prognostic prediction. (Cardiol J 2019; 26, 6: 696–703) |
format | Online Article Text |
id | pubmed-8083050 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Via Medica |
record_format | MEDLINE/PubMed |
spelling | pubmed-80830502021-05-10 The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease Chen, Fei Li, Jia-qi Ou, Yuan-Wei-Xiang Xia, Tian-li Huang, Fang-yang Chai, Hua Huang, Bao-tao Li, Qiao Pu, Xiao-bo Li, Guo-yong Peng, Yong Chen, Mao Huang, De-jia Cardiol J Clinical Cardiology BACKGROUND: The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide (NT-proBNP) remains unclear in coronary artery disease (CAD). This study sought to investigate the value of using NT-proBNP level to predict prognoses of CAD patients with different estimated glomerular filtration rates (eGFRs). METHODS: A retrospective analysis was conducted from a single registered database. 2087 consecutive patients with CAD confirmed by coronary angiography were enrolled. The primary endpoint was allcause mortality. RESULTS: The mean follow-up time was 26.4 ± 11.9 months and death events occurred in 197 cases. The NT-proBNP levels increased with the deterioration of renal function, as well as the optimal cutoff values based on eGFR stratification to predict endpoint outcome (179.4 pg/mL, 1443.0 pg/mL, 3478.0 pg/mL, for eGFR ≥ 90, 60–90 and < 60 mL/min/1.73 m(2), respectively). Compared with the routine cut-off value or overall optimal one, stratified optimal ones had superior predictive ability for endpoint in each eGFR group (all with the highest Youden’s J statistics). And the prognostic value became weaker as eGFR level decreased (eGFR ≥ 90 vs. 60–90 vs. < 60 mL/min/1.73 m(2), odds ratio [OR] 7.7; 95% confidence interval [CI] 1.7–33.9 vs. OR 4.8; 95% CI 2.7–8.5 vs. OR 3.0; 95% CI 1.5–6.2). CONCLUSIONS: This study demonstrated that NT-proBNP exhibits different predictive values for prognosis for CAD patients with different levels of renal function. Among the assessed values, the NT-proBNP cut-off value determined using renal function improve the accuracy of the prognosis prediction of CAD. Moreover, lower eGFR is associated with a higher NT-proBNP cut-off value for prognostic prediction. (Cardiol J 2019; 26, 6: 696–703) Via Medica 2020-01-22 /pmc/articles/PMC8083050/ /pubmed/29611168 http://dx.doi.org/10.5603/CJ.a2018.0031 Text en Copyright © 2019 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. |
spellingShingle | Clinical Cardiology Chen, Fei Li, Jia-qi Ou, Yuan-Wei-Xiang Xia, Tian-li Huang, Fang-yang Chai, Hua Huang, Bao-tao Li, Qiao Pu, Xiao-bo Li, Guo-yong Peng, Yong Chen, Mao Huang, De-jia The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease |
title | The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease |
title_full | The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease |
title_fullStr | The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease |
title_full_unstemmed | The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease |
title_short | The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease |
title_sort | impact of renal function on the prognostic value of n-terminal pro–b-type natriuretic peptide in patients with coronary artery disease |
topic | Clinical Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083050/ https://www.ncbi.nlm.nih.gov/pubmed/29611168 http://dx.doi.org/10.5603/CJ.a2018.0031 |
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