Utilidad pronóstica de valores extremos de NT-proBNP en pacientes ingresados por insuficiencia cardíaca

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica Pub Date : 2025-05-22 DOI:10.1016/j.medcli.2025.106990

Miguel Yebra Yebra , Alejandro Sáenz de Urturi Rodríguez , Sergio González García , Paula de Peralta García , Maria Asenjo Martínez , Jose Antonio Rueda Camino , Raquel Barba Martín

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引用次数: 0

Abstract

Background and objective

To evaluate the prognostic value of extreme levels of the N-terminal pro-brain natriuretic peptide (NT-proBNP) measured at any time during hospitalization for heart failure (HF).

Materials and methods

A retrospective cohort study including patients hospitalized for HF in a secondary-level hospital with at least one NT-proBNP measurement. Two groups were defined: patients with extreme NT-proBNP levels (> 50,000 pg/mL) and those with elevated NT-proBNP levels (> 1800 pg/mL and < 20,000 pg/mL). The primary outcome was a composite of (1) in-hospital mortality; (2) HF readmission, and (3) 6-month mortality. Cox survival models were used for analysis.

Results

A total of 83 patients with extreme NT-proBNP levels and 100 with elevated NT-proBNP levels were included; 61% were women, with a median age of 87 years. Comorbidity burden was high and similar between groups (median Charlson index: 8). The primary outcome was more frequent in patients with extreme NT-proBNP levels: 25.02 vs. 10.53 events per 100 patient-months (HR 2.07; 95% CI: 1.37-3.14). Both in-hospital and 6-month mortality were significantly higher in the extreme NT-proBNP group, while HF readmissions were numerically higher but not statistically significant. These results remained consistent after multivariable adjustment.

Conclusions

Patients hospitalized for HF with NT-proBNP levels > 50,000 pg/mL have a worse prognosis than those with NT-proBNP < 20,000 pg/mL, representing a high-risk subgroup with short-term mortality.

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NT-proBNP极值对心脏衰竭住院患者的预测效用

背景与目的评价因心力衰竭（HF）住院期间任何时间测量的n端脑利钠肽前体（NT-proBNP）极端水平的预后价值。材料和方法一项回顾性队列研究，纳入至少有一项NT-proBNP测量的二级医院心衰住院患者。分为两组：NT-proBNP水平极端的患者(>；50,000 pg/mL)和NT-proBNP水平升高的患者(>；1800 pg/mL和<；20000 pg / mL)。主要终点是以下综合指标：(1)住院死亡率；(2) HF再入院，(3)6个月死亡率。采用Cox生存模型进行分析。结果共纳入NT-proBNP极端患者83例，NT-proBNP升高患者100例；61%为女性，中位年龄为87岁。两组共病负担高且相似（Charlson指数中位数：8）。主要结局在NT-proBNP水平极端的患者中更为常见：25.02 vs 10.53事件/ 100患者-月(HR 2.07；95% ci: 1.37-3.14)。极端NT-proBNP组的住院死亡率和6个月死亡率均显著高于极端NT-proBNP组，而HF再入院率在数字上较高，但无统计学意义。这些结果在多变量调整后保持一致。结论心衰住院患者NT-proBNP水平与gt；50,000 pg/mL的预后较NT-proBNP和lt患者差；20000 pg/mL，属于短期死亡率高的高危亚组。

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

Medicina Clinica 医学-医学：内科

CiteScore

3.10

自引率

5.10%

发文量

295

审稿时长

22 days

期刊介绍： Medicina Clínica, fundada en 1943, es una publicación quincenal dedicada a la promoción de la investigación y de la práctica clínica entre los especialistas de la medicina interna, así como otras especialidades. Son características fundamentales de esta publicación el rigor científico y metodológico de sus artículos, la actualidad de los temas y, sobre todo, su sentido práctico, buscando siempre que la información sea de la mayor utilidad en la práctica clínica.