Rationale and design of PRIMA II: A multicenter, randomized clinical trial to study the impact of in-hospital guidance for acute decompensated heart failure treatment by a predefined NT-PRoBNP target on the reduction of readmIssion and Mortality rAtes

Stienen, Susan; Salah, Khibar; Moons, A H M; Bakx, Adrianus L.M.; Pol, Petra E. van; Schroeder‐Tanka, Jutta M.; Voogel, A. J.; Keijer, J.; Kortz, R.A. Mikael; Dickhoff, Cathelijne; Meregalli, Paola G.; Tijssen, Jan G.P.; Pinto, Yigal M.; Kok, Wouter E.

doi:10.1016/j.ahj.2014.04.008

Cited by 36 publications

(18 citation statements)

References 30 publications

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“…17,18) Paulo, et al 19) enrolled 182 subjects and revealed that the admission NT-proBNP level was not an independent predictor for in-hospital mortality. However, several studies have observed a close relationship between admission NT-proBNP and HF prognosis.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Long-Term Mortality in Patients With Acute Heart Failure

et al. 2017

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SummaryTo investigate parameters which were related with long-term mortality in patients hospitalized for acute heart failure (AHF).A total of 287 patients with AHF presenting to the First Affiliated Hospital of Nanjing Medical University were enrolled into the registry from April 2012 to January 2015. The primary endpoint was all-cause mortality within 1 year; the association between variables and prognosis was assessed after 1 year.Among the 287 patients, 17 did not continue follow-up and 47 (17.4%) passed away. Baseline NT-proBNP and sST2 concentrations were higher amongst deceased than among survivors (P < 0.001). Serum sodium concentrations of patients who died were lower (P < 0.001). In receiver operator characteristics (ROC) analyses, the area under the curve (AUC) values for NT-proBNP, sST2, and serum sodium to predict 1-year mortality were 0.699 (95%CI 0.639-0.755), 0.692, (95%CI 0.634-0.747), and 0.694 (95%CI 0.634-0.750), respectively. The optimal cut-off points for NT-proBNP, sST2, and serum sodium were 2137.0 ng/L, 35.711 ng/mL, and 136.6 mmol/L, respectively. In Cox regression analysis, ln-transformed NT-proBNP (HR 1.546, P = 0.039), ln-transformed sST2 (HR1.542, P = 0.049), and serum sodium (HR 0.880, P = 0.000) values reliably predicted long-term mortality after multivariable adjustment.In patients with acute heart failure, NT-proBNP, sST2 and serum sodium are potential predictors of 1-year mortality. (Int Heart J 2017; 58: 409-415)

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Section: Discussionmentioning

confidence: 99%

Predictors of Long-Term Mortality in Patients With Acute Heart Failure

et al. 2017

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“…Rationale and design of the study have been previously reported [9]. This substudy was approved by the Medical Ethics Committee of the University of Amsterdam and Academic Medical Center, The Netherlands and written informed consent was obtained from all patients.…”

Section: Original Cohortmentioning

confidence: 99%

“…Patients were randomized at the day of clinical stability, a discharge criterion requiring the presence of 3 of 4 clinical variables [9]. No attempts were made to adjust therapy using these measurements before randomization.…”

Section: Original Cohortmentioning

confidence: 99%

“…Several studies have demonstrated that a relative NT-proBNP reduction of ≤30% at discharge for ADHF is a significant predictor of readmissions and mortality [2 3 6 8]. A role for NT-proBNP-guided ADHF treatment targeting a reduction of >30% is therefore suggested [9]. Whether an NT-proBNP target can be set at a time point well before discharge (at for example day 2 or 3) is unknown.…”

Section: Introductionmentioning

confidence: 98%

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N-Terminal Pro–B-Type Natriuretic Peptide (NT-proBNP) Measurements Until a 30% Reduction Is Attained During Acute Decompensated Heart Failure Admissions and Comparison With Discharge NT-proBNP Levels: Implications for In-Hospital Guidance of Treatment

Stienen

Salah

Dickhoff

et al. 2015

Journal of Cardiac Failure

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“…[2][3][4] Besides, the reduction in NT-proBNP levels directly reflects blood volume response to diuretic therapy. [5][6][7] NT-proBNP in acute heart failure; hospital admission versus discharge Int J Cardiovasc Sci. 2017;30(6)469-475…”

Section: Introductionmentioning

confidence: 99%

NT-ProBNP at Admission Versus NT-ProBNP at Discharge as a Prognostic Predictor in Acute Decompensated Heart Failure

Magalhães

Soares

Noya

et al. 2017

International Journal of Cardiovascular Sciences

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Background: Patients admitted for decompensated heart failure (HF) receive intensive diuretic and vasodilator therapy in the first days. Normally, this is a successful approach that leads to HF compensation and hospital discharge. However, recurrences within the first week of discharge are common.Objective: to evaluate whether the main predictor of recurrent outcomes in patients with HF is the severity of decompensation at admission or patient's blood volume after clinical management.Methods: Prospective, cohort study of patients admitted between January 2013 and October 2014, with diagnosis of acute decompensated HF, who were followed-up for 60 days after discharge. Inclusion criterion was increased plasma NT-proBNP (> 450 pg/mL for patients younger than 50 years or > 900 pg/mL for patients older than 50 years). Primary outcome was the combination of cardiovascular death with rehospitalization for decompensated HF in 60 days.Results: Ninety patients were studied, with median NT-proBNP at admission of 3,947pg/mL (IQR: 2,370 -7,000 pg/mL), and median NT-proBNP at discharge of 1,946pg/mL (IQR: 1,000 -3,781 pg/mL). The incidence of combined outcome was 30% (12.2% of deaths and 20% of rehospitalization). The area under the ROC curve for NT-proBNP at admission and 60-day cardiovascular events was 0.49 (p = 0.89; 95% CI = 0.36 -0.62). The area under the curve of NT-proBNP absolute variation for 60 day-events was 0.65 (p = 0.04; 95%CI = 0.51 -0.79), and the area under the curve for NT-BNP at discharge was 0.69 (p = 0.03; 95%CI = 0.58 -0.80). In the multivariate analysis, pre-discharge NT-proBNP was a predictor of the primary outcome, independently of the NT-proBNP at admission and other risk factors. Conclusion:Different from the severity of decompensation at hospitalization, blood volume after compensation of HF is associated with recurrent event. This finding suggests that, regardless of initial severity, therapy response during hospitalization is determinant of the risk of recurrent decompensation. (Int J Cardiovasc Sci. 2017;30(6) [469][470][471][472][473][474][475]

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Rationale and design of PRIMA II: A multicenter, randomized clinical trial to study the impact of in-hospital guidance for acute decompensated heart failure treatment by a predefined NT-PRoBNP target on the reduction of readmIssion and Mortality rAtes

Cited by 36 publications

References 30 publications

Predictors of Long-Term Mortality in Patients With Acute Heart Failure

Predictors of Long-Term Mortality in Patients With Acute Heart Failure

N-Terminal Pro–B-Type Natriuretic Peptide (NT-proBNP) Measurements Until a 30% Reduction Is Attained During Acute Decompensated Heart Failure Admissions and Comparison With Discharge NT-proBNP Levels: Implications for In-Hospital Guidance of Treatment

NT-ProBNP at Admission Versus NT-ProBNP at Discharge as a Prognostic Predictor in Acute Decompensated Heart Failure

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