Incremental value of B-type natriuretic peptide for early risk prediction of infective endocarditis

Siciliano, Rinaldo Focaccia; Gualandro, Danielle Menosi; Müeller, Christian; Seguro, Luis Fernando Bernal da Costa; Goldstein, Priscila Gherardi; Strabelli, Tânia Mara Varejão; Arias, Victor; Accorsi, Tarso Augusto Duenhas; Grinberg, Max; Mansur, Alfredo José; Oliveira, Múcio Tavares de

doi:10.1016/j.ijid.2014.08.017

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…In addition, Siciliano et al. 17 extended previous pilot studies to show that BNP was an independent predictor of in-hospital mortality in 104 patients with IE. However, the small sample size and lack of long-term follow-up limited the evidence of NT-proBNP for predicting poor outcomes in patients with IE.…”

Section: Discussionmentioning

confidence: 85%

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Prognostic value of N-terminal prohormone brain natriuretic peptide for in-hospital and long-term outcomes in patients with infective endocarditis

Wei

Liu

et al. 2017

Eur J Prev Cardiolog

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Background Limited research studies with a large sample size were performed to evaluate the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for in-hospital or long-term poor outcomes in patients with infective endocarditis. Methods A total of 703 patients with infective endocarditis were enrolled and divided into four groups according to admission NT-pro-BNP (pg/mL) quartiles: Q1 (<258), Q2 (258-1054), Q3 (1055-3522) and Q4 (>3522). Multivariate regression was used to determine independent risk of NT-proBNP for in-hospital and one-year death. Results In-hospital death occurred in 9.0% of patients. The in-hospital mortality was increased from the lowest to the highest NT-proBNP quartiles (1.1%, 3.4%, 9.1% and 22.3%, P < 0.001, respectively). During the one-year follow-up period, 29 patients died: 0 in Q1, 7 (4.6%) in Q2, 8 (5.7%) in Q3 and 14 (12.0%) in Q4 ( P < 0.001). Log-transformed (lg) NT-proBNP had a linear correlation with lg C-reactive protein ( r = 0.308, P < 0.001). Multivariate analysis showed lgNT-proBNP was an independent predictor for both in-hospital (odds ratio 4.59, 95% confidence interval (CI) 2.45-8.61, P < 0.001) and one-year mortality (hazard ratio 3.11, 95% CI 1.65-5.87, P < 0.001). In addition, NT-proBNP had a higher predictive power for in-hospital death than C-reactive protein (area under the curve 0.797 vs. 0.670, P = 0.005). NT-proBNP > 2260 pg/mL had 76.2% sensitivity and 69.1% specificity for predicting in-hospital death. Kaplan-Meier analysis showed that patients with NT-proBNP > 2260 pg/ml had a worse prognosis than those without (log-rank test 18.84, P < 0.001). Conclusion Increased NT-proBNP was independently associated with in-hospital and one-year mortality in patients with infective endocarditis.

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Section: Discussionmentioning

confidence: 85%

“…The largest sample was 104 patients. 17 In addition, the outcomes of these studies were limited to in-hospital. The impact of NT-proBNP on long-term outcomes in patients with IE remained unclear.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of N-terminal prohormone brain natriuretic peptide for in-hospital and long-term outcomes in patients with infective endocarditis

Wei

Liu

et al. 2017

Eur J Prev Cardiolog

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“…In a retrospective study among 50 patients, Cornelissen et al 21 found leukocytosis, elevated C-reactive protein (CRP) levels and elevated procalcitonin as independent predictors of complications. Other predictors that have been studied and found useful include brain-type natriuretic peptide (BNP) levels, 22 neutrophil-to-lymphocyte ratio, 23 D-dimer levels 24 and mean platelet volumes 25 . Although serial monitoring of CRP levels is proven to have a role in predicting treatment outcomes, the value of CRP level at admission has been scantily studied 26, 27, 28.…”

Section: Introductionmentioning

confidence: 99%

Baseline C-reactive protein levels and prognosis in patients with infective endocarditis: A prospective cohort study

Mohanan

Nair

Vellani

et al. 2018

Indian Heart Journal

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BackgroundEarly diagnosis and risk-stratification among infective endocarditis (IE) patients are limited by poor microbiological yield and inadequate characterization of vegetations. A simple tool that can predict adverse outcomes in the early phase of management is required.AimTo study the prognostic value of C-reactive protein (CRP) levels at admission and its role in predicting various clinical outcomes.MethodsIn a prospective study of consecutive IE patients diagnosed by modified Duke’s criteria, we measured the peak levels of CRP and erythrocyte sedimentation rate (ESR) in the first 3 days of admission and correlated it with in-hospital mortality, six-month mortality, embolic phenomena and the need for urgent surgery. Predefined laboratory-microbiological sampling protocols and antibiotic-initiation protocols were followed. Receiver-operating-characteristics curves were generated to identify a reliable cut-off for CRP in predicting various outcomes.ResultsOut of 101 patients who were treated, 85 patients had ‘definite’ IE. Blood cultures were positive in 55% (n = 39); and Staphylococcus species was the most common organism. Major complications occurred in 74.1% (n = 63) and in-hospital mortality was 32.9% (n = 28). Mean ESR and CRP levels were 102 ± 31 mm/h and 51 ± 20 mg/l, respectively. In multivariable analysis, high CRP levels were independently predictive of mortality, major complications, embolic events and need for urgent surgery. A CRP >40 mg/l predicted adverse outcomes with a sensitivity of 73% and specificity of 99%.ConclusionThe study shows that baseline CRP level in the first 3 days of admission is a strong predictor of short term adverse outcomes in IE patients, and a useful marker for early risk stratification.

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“…Some studies have reported lower prevalence rates compared to the current study. For example, in Brazil, only 2.06% isolates contained blaNDM, and 0.72% blaVIM [27]. In another study, of 170 K. pneumoniae clinical isolates four became positive for blaNDM [28].…”

Section: Vol 8 Nomentioning

confidence: 96%

Antibiotic Resistance among Klebsiella pneumoniae Isolates by Detecting blaVIM and blaNDM Genes

Bandari

Keyvani

Abootaleb

2020

JoMMID

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Introduction: The emergence of extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacteriaceae, especially Klebsiella pneumoniae isolates, has become a severe concern worldwide. This study aimed to determine the prevalence of blaVIM and blaNDM genes among K. pneumoniae isolates. Methods: One hundredeighty-one K. pneumoniae isolates were obtained from different clinical specimens of patients hospitalized at Firoozgar hospital, Tehran, Iran. The isolates were identified by standard biochemical tests, and their identity was confirmed by Vitek 2 (bioMérieux, France), a fully automated system for bacterial identification. The isolates were subjected to antimicrobial susceptibility testing and screened for ESBL by double-disc synergy test (DDST) and modified Hodge test (MHT) for the detection of carbapenemase. PCR was also used to detect the presence of blaVIM and blaNDM resistance genes in the isolates. Results: The Vitek 2 system confirmed the biochemical test results. The highest and lowest rates of resistance to antibiotics belonged to cefepime (83.9%) and imipenem (55.2%). Eighty-six and 100 isolates showed to produce ESB and KPC by DDST and MHT, respectively. About 71% and 97% of the 100 isolates were positive for blaVIM and blaNDM genes, respectively. Conclusion: The high rate of ESBL-and KPC-producing K. pneumoniae isolates in our hospital setting revealed resistance to conventional antibiotics, which limit our options in choosing appropriate antimicrobials. Although the management of infections associated with these organisms is challenging, it is essential to control such strains to prevent the outbreak.

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Incremental value of B-type natriuretic peptide for early risk prediction of infective endocarditis

Abstract: Among patients with IE, BNP levels obtained on admission provide incremental value for early and accurate risk prediction.

Cited by 12 publications

References 27 publications

Prognostic value of N-terminal prohormone brain natriuretic peptide for in-hospital and long-term outcomes in patients with infective endocarditis

Prognostic value of N-terminal prohormone brain natriuretic peptide for in-hospital and long-term outcomes in patients with infective endocarditis

Baseline C-reactive protein levels and prognosis in patients with infective endocarditis: A prospective cohort study

Antibiotic Resistance among Klebsiella pneumoniae Isolates by Detecting blaVIM and blaNDM Genes

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