A two-centre study investigating the association between brain natriuretic peptides & outcomes in continuous flow left ventricular assist device recipients.

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Maria Lambadaris, Farid Foroutan, Julie Kk Vishram-Nielsen, Marie Sophie S Knudsen, Filio Billia, Vivek Rao, Finn Gustafsson, Ana C Alba
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引用次数: 0

Abstract

Background: Natriuretic peptides are useful prognostic markers in patients with heart failure and this study aims to evaluate the association between N-terminal pro-brain natriuretic peptide and outcomes in patients with a continuous-flow left ventricular assist device.

Methods: Adult patients with a continuous-flow left ventricular assist device as bridge to transplant or destination therapy and discharged from hospital were included in the study. Multi-variable Cox regression models with natriuretic peptide as a time-dependent covariate modelling multiple measures per patient, and cubic spline analysis were used to evaluate the association between natriuretic peptides and patient outcomes, taking median N-terminal pro-brain natriuretic peptide of 244 pmol/L as the reference value. Heart transplant was considered a competing event for mortality analysis, while death was considered a competing event for transplantation analysis. A multivariable cause-specific Cox regression model evaluated the relationship between natriuretic peptides and heart failure hospitalizations while considering heart failure hospitalizations as recurring events and adjusting for competing risks of death and transplant.

Results: This retrospective cohort study included 161 adults. During a median follow-up of 4.7 years, 49 patients died, 79 received a heart transplant and 66 were hospitalized for heart failure. In comparison to the median N-terminal pro-brain natriuretic peptide level, patients exceeding 350 pmol/L had a 19% increased mortality (HR 1.19, 95%CI 1.01-1.15) while patients exceeding 330 pmol/L had a 16% higher risk of hospitalization (HR 1.16, 95%CI 1.01-1.12).

Conclusion: In patients with a continuous-flow left ventricular assist device, serial assessments of natriuretic peptides may help provide personalized patient care.

一项研究脑利钠肽与连续血流左心室辅助装置接受者预后之间关系的双中心研究。
背景:利钠肽是心衰患者有用的预后标志物,本研究旨在评估n端脑利钠肽前体与连续血流左心室辅助装置患者预后之间的关系。方法:采用连续血流左心室辅助装置作为移植或终点治疗的桥梁并出院的成年患者纳入研究。采用多变量Cox回归模型,以利钠肽为时间相关协变量,对每位患者的多项指标进行建模,并采用三次样条分析评估利钠肽与患者预后的关系,以244 pmol/L的中位n端脑利钠肽前体为参考值。心脏移植被认为是死亡率分析的竞争事件,而死亡被认为是移植分析的竞争事件。多变量病因特异性Cox回归模型评估了利钠肽与心力衰竭住院之间的关系,同时将心力衰竭住院视为反复发生的事件,并调整了死亡和移植的竞争风险。结果:这项回顾性队列研究包括161名成年人。在平均4.7年的随访期间,49名患者死亡,79名接受心脏移植,66名因心力衰竭住院。与中位n端前脑利钠肽水平相比,超过350 pmol/L的患者死亡率增加19% (HR 1.19, 95%CI 1.01-1.15),而超过330 pmol/L的患者住院风险增加16% (HR 1.16, 95%CI 1.01-1.12)。结论:在使用连续血流左心室辅助装置的患者中,利钠肽的连续评估可能有助于提供个性化的患者护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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