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)...

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Autores: Cordero A, Martínez Rey-Rañal E, Moreno MJ, Escribano D, Moreno-Arribas J, Quintanilla MA, Zuazola P, Núñez J, Bertomeu-González V
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2021
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositório:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p9402
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/9402
Access Level:Acceso aberto
Palavra-chave:pro-BNP
heart failure
acute coronary syndrome
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spelling Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary SyndromeCordero AMartínez Rey-Rañal EMoreno MJEscribano DMoreno-Arribas JQuintanilla MAZuazola PNúñez JBertomeu-González Vpro-BNPheart failureacute coronary syndromeBackground: 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.MDPI2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/9402Journal of Clinical MedicineISSN: 20770383reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p94022026-06-11T12:45:17Z
dc.title.none.fl_str_mv 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
spellingShingle Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
Cordero A
pro-BNP
heart failure
acute coronary syndrome
title_short 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_sort Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
dc.creator.none.fl_str_mv Cordero A
Martínez Rey-Rañal E
Moreno MJ
Escribano D
Moreno-Arribas J
Quintanilla MA
Zuazola P
Núñez J
Bertomeu-González V
author Cordero A
author_facet Cordero A
Martínez Rey-Rañal E
Moreno MJ
Escribano D
Moreno-Arribas J
Quintanilla MA
Zuazola P
Núñez J
Bertomeu-González V
author_role author
author2 Martínez Rey-Rañal E
Moreno MJ
Escribano D
Moreno-Arribas J
Quintanilla MA
Zuazola P
Núñez J
Bertomeu-González V
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv pro-BNP
heart failure
acute coronary syndrome
topic pro-BNP
heart failure
acute coronary syndrome
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.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/9402
url https://fisabio.portalinvestigacion.com/publicaciones/9402
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Journal of Clinical Medicine
ISSN: 20770383
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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