Primary Results of the HABIT Trial (Heart Failure Assessment With BNP in the Home)

Maisel, Alan S.; Barnard, Denise; Jaski, Brian E.; Frivold, Geir; Marais, John; Azer, Maged; Miyamoto, Michael I.; Lombardo, Dawn; Kelsay, Damon; Borden, Kelly; Iqbal, Navaid; Taub, Pam R.; Kupfer, Ken; Clopton, Paul; Greenberg, Barry D.

doi:10.1016/j.jacc.2013.01.052

Cited by 93 publications

(70 citation statements)

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“…A research project aimed to implement BNP monitoring in the home (the HABIT trial) showed that patients can be taught to take their own blood for testing [4]. The present finding of a stable relationship between relative changes in plasma and urinary concentrations of NT-proBNP over a period of HF treatment optimization opens the possibility of using urine analysis to monitor HF in the home care setting.…”

Section: Discussionmentioning

confidence: 63%

“…Changes in the amino-terminal pro-hormone brain natriuretic peptide (NTproBNP) level during in-hospital treatment are strong predictors of mortality and early readmission [2][3][4]; therefore, NT-proBNP levels might be successfully used to guide the treatment of HF patients. An increase in NT-proBNP concentration indicates a worsening of the condition and, together with worsening symptoms, may call for a period of hospitalization or intensified treatment in the patient's home [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…An increase in NT-proBNP concentration indicates a worsening of the condition and, together with worsening symptoms, may call for a period of hospitalization or intensified treatment in the patient's home [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Measuring NT-proBNP at home is feasible [4], but it is complicated by the fact that BNP requires blood sampling. Urinary analysis of NTproBNP could be performed more easily, and recent studies show that NT-proBNP may be measured not only in the blood but also in the urine [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Urine measurement indicates the plasma brain natriuretic peptide concentration during optimization of heart failure treatment

Hahn

Jaarsma

Waldréus

et al. 2015

Scandinavian Journal of Clinical and Laboratory Investigation

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Aim: To assess the correlation between the amino-terminal pro-hormone brain natriuretic peptide (NT-proBNP) concentration in blood and urine during a period when actively adjusting the treatment of heart failure (HF). Methods: Plasma and urine analyses of NT-proBNP were compared in 51 patients on admission to and discharge from a nurse-led outpatient clinic where HF treatment was optimized. The median time between the two measurements was 42 days. Correlations were analyzed using linear regression, where R-2 is the degree of variability in the plasma NT-proBNP concentration that can be accounted for by the urinary NT-proBNP. Results: There was a statistically significant linear relationship between the urine and plasma concentrations of NT-proBNP on both occasions, but R-2 varied greatly depending on how the data were presented. The correlation between the raw data showed an R-2 of only 30%, and it almost doubled upon logarithm transformation, which shows that the variability (error) was concentration-dependent. Correction of the urinary NT-proBNP for urinary creatinine further increased R-2 for the logarithm-transformed correlation to 68% on admission and 76% on discharge. The highest R-2 (77%) was obtained when the relative changes in urinary NT-proBNP/creatinine between admission and discharge were compared with the corresponding relative changes in the plasma concentration. The sensitivity and specificity of the urine in indicating plasma concentration changes > 10% were 82% and 86%, respectively. Conclusion: Relative changes in plasma NT-proBNP could be reliably estimated from urine samples during a period of optimization of HF treatment

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Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Urine measurement indicates the plasma brain natriuretic peptide concentration during optimization of heart failure treatment

Hahn

Jaarsma

Waldréus

et al. 2015

Scandinavian Journal of Clinical and Laboratory Investigation

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“…The BNP peptides are effective at diagnosing HF among patients with dyspnea [14], ruling out acute decompensated HF [15], and future adverse cardiovascular events and mortality among patients [36,37]. They are also used to guide HF therapy [8,38]. High sensitivity troponin release in the absence of coronary hypoperfusion is also a marker of ongoing myocyte injury and necrosis [39][40][41][42][43].…”

Section: Cs Distinguishes Failing Cardiac Muscle From Hf Comorbiditiesmentioning

confidence: 99%

Plasma cBIN1 Score (CS) Identifies HFrEF and Can Predict Cardiac Hospitalization in Stable Ambulatory Patients

Xie¹,

Hitzeman²,

Zadikany³

et al. 2018

Preprint

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Objective: We determined, in stable ambulatory heart failure with reduced ejection fraction (HFrEF) subjects and matched controls, the capability of a novel blood based cardiac-specific cBIN1 Score (CS), which assesses the health of cardiac muscle, to identify patients with known heart failure (HF) and to prognosticate future hospitalization.Background: Limited clinical tools are available in assessing cardiac muscle health in stable

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Association of Visit-to-Visit Variability in Kidney Function and Serum Electrolyte Indexes With Risk of Adverse Clinical Outcomes Among Patients With Heart Failure With Preserved Ejection Fraction

Segar

Patel

et al. 2020

JAMA Cardiol

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and abnormalities in serum electrolyte levels are associated with poor clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF), the association of visit-to-visit variability in such laboratory measures with long-term outcomes is unclear.OBJECTIVE To evaluate the associations of visit-to-visit variability in indexes of kidney function (creatinine and blood urea nitrogen [BUN] levels) and serum electrolyte (sodium, chloride, and potassium) with the risk of adverse clinical outcomes among patients with chronic, stable HFpEF. DESIGN, SETTING, AND PARTICIPANTSThis cohort analysis used data from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial. All participants with 3 or more serial laboratory measurements who were event free within the first 4 months of enrollment were included. Data were analyzed from March 1, 2019, to January 31, 2020. MAIN OUTCOMES AND MEASURESAdjusted associations between indexes of variability in serum laboratory measurements during the first 4 months of follow-up and risk of the primary composite outcome (a composite of aborted cardiac arrest, hospitalization for heart failure, or cardiovascular death) and all-cause mortality were assessed using Cox proportional hazards regression models. RESULTSOf the 3445 patients enrolled in the TOPCAT trial (mean [SD] age, 68-69 [10] years; 49.7%-51.5% female), 2479 (BUN) to 3195 (potassium) were analyzed, depending on availability of serial measurements. Participants with higher laboratory variability in kidney function parameters were older, had more comorbidities, and had more severe symptoms of HFpEF. Higher visit-to-visit variability in BUN (hazard ratio [HR] per 1-SD higher average successive variability [ASV], 1.21; 95% CI, 1.10-1.33) and creatinine (HR per 1-SD higher ASV, 1.13; 95% CI, 1.04-1.22) were independently associated with a higher risk of the primary composite outcome as well as mortality independent of other baseline confounders, changes in kidney function, changes in medication dosages, and variability in other cardiometabolic parameters (systolic blood pressure and body mass index). The higher risk associated with greater variability in kidney function was consistent across subgroups of patients stratified by the presence of chronic kidney disease (CKD) at baseline (CKD: HR per 1-SD higher ASV, 1.39; 95% CI, 1.16-1.67 and no CKD: HR per 1-SD higher ASV, 1.13; 95% CI, 1.01-1.27), among placebo and spironolactone treatment arms separately (spironolactone arm: 1.30; 95% CI, 1.03-1.65 and placebo arm: HR per 1-SD higher ASV, 1.27; 95% CI, 1.04-1.56). Among serum electrolytes, variability in sodium and potassium measures were also significantly associated with a higher risk of primary composite events (sodium: HR per 1-SD higher ASV, 1.14; 95% CI, 1.01-1.30 and potassium: HR per 1-SD higher ASV, 1.21; 95% CI, 1.02-1.44). CONCLUSIONS AND RELEVANCEIn HFpEF, visit-to-visit variability in laboratory indexes of kidney function and serum electrolytes is common ...

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Primary Results of the HABIT Trial (Heart Failure Assessment With BNP in the Home)

Cited by 93 publications

References 23 publications

Urine measurement indicates the plasma brain natriuretic peptide concentration during optimization of heart failure treatment

Urine measurement indicates the plasma brain natriuretic peptide concentration during optimization of heart failure treatment

Plasma cBIN1 Score (CS) Identifies HFrEF and Can Predict Cardiac Hospitalization in Stable Ambulatory Patients

Association of Visit-to-Visit Variability in Kidney Function and Serum Electrolyte Indexes With Risk of Adverse Clinical Outcomes Among Patients With Heart Failure With Preserved Ejection Fraction

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