Valor pronóstico del NT-proBNP en pacientes con enfermedad pulmonar crónica reagudizada

Sánchez‐Marteles, Marta; Medina, Araceli Molina; Saiz, E. Bermejo; Laiglesia, F. Ruiz; Rodríguez, José Antonio; Pérez-Calvo, Juan Ignacio

doi:10.1016/j.medcli.2009.11.047

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…A concentration of NTproBNP above 500 pg/mL increased the risk of death 11-fold, and above a concentration as low as 350 pg/mL, prescription of diuretics was three-fold that of patients below this level. 17 We could hypothesize that ‘de novo’ prescriptions of diuretics could be a surrogate marker of ventricular dysfunction, clinically manifested by the appearance of oedema. If this interpretation were correct, NTproBNP and CysC might act as early predictors of subclinical ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Differential prognostic utility of NTproBNP and Cystatin C in patients with acute exacerbation of chronic pulmonary disease

Pérez-Calvo

Sánchez‐Marteles

et al. 2010

JRSM Short Reports

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ObjectivesTo determine whether serum Cystatin C (CysC) and NTproBNP have prognostic value among patients with long-standing chronic lung disease.DesignProspective, observational, non-interventional study.SettingCysC and NTproBNP are prognostic markers in several cardiac conditions. In addition, CysC acts as an antiprotease following Cathepsin activation, which has been involved in the pathogenesis of chronic obstructive pulmonary disease.ParticipantsPatients with a basal functional status of II-IV (NYHA), admitted for an acute exacerbation of chronic pulmonary diseases and no previous history of symptoms related to pulmonary hypertension or heart failure.Main outcome measuresNTproBNP and CysC were determined at admission in 107 patients with acute exacerbation of chronic lung disease. During 12-month follow-up, mortality, new hospital admissions and prescription of diuretics were recorded.ResultsDuring follow-up there were eight patient deaths (7.5%). Mean NTproBNP among the deceased was 1510.20 pg/mL (95% CI 498.44–4628.55) vs 502.70 pg/mL (95% CI 395.44–645.48) among survivors (p = 0.01). Twenty-seven patients (25%) were prescribed loop diuretics. Mean concentration of CysC was 1.45 mg/dL (95% CI 1.21–1.69 mg/dL) vs 1.17 mg/dL (95% IC 1.09–1.25 mg/dL) in those not prescribed (p = 0.004). NTproBNP concentration was 837.14 pg/mL (95% CI 555.57–1274.10 pg/mL) in patients prescribed diuretics vs 473.42 pg/mL (95% CI 357.80–632.70 pg/mL) in those not prescribed (p = 0.03). Kaplan-Meier analysis revealed a significant difference between death and diuretic prescription during follow-up when cut-off value for NTproBNP was 550 pg/mL (p = 0.03 and p = 0.02, respectively). For 1.16mg/dL of CsysC, a significant difference was only observed in diuretic prescription (p = 0.007).ConclusionsIn patients with chronic respiratory diseases NTproBNP has predictive value in terms of mortality whereas CysC does not. However, it is still possible that both can contribute to the early identification of patients at risk of developing clinical ventricular dysfunction.

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Section: Discussionmentioning

confidence: 99%

“…Raised NTproBNP concentrations have been found in patients with chronic lung diseases, 13 cor pulmonale 14,15 and pulmonary embolism. 16 B-type natriuretic peptide was a short-term independent predictor of mortality in patients with chronic lung disease 13,17 and primary pulmonary hypertension. 18 …”

Section: Introductionmentioning

confidence: 93%

Differential prognostic utility of NTproBNP and Cystatin C in patients with acute exacerbation of chronic pulmonary disease

Pérez-Calvo

Sánchez‐Marteles

et al. 2010

JRSM Short Reports

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Péptidos natriuréticos: ¿nuevas indicaciones?

Bayés‐Genís¹

2010

Medicina Clínica

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B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

et al. 2017

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BackgroundPatients with chronic obstructive pulmonary disease (COPD) have increased cardiovascular risk. Natriuretic peptides (NP) in other populations are useful in identifying cardiovascular disease, stratifying risk, and guiding therapy.MethodsWe performed a systematic literature review to examine NP in COPD, utilising Medline, EMBASE, and the Cochrane Library.ResultsFifty one studies were identified. NP levels were lower in stable compared to exacerbation of COPD, and significantly increased with concomitant left ventricular systolic dysfunction or cor pulmonale. Elevation occurred in 16 to 60% of exacerbations and persisted in approximately one half of patients at discharge. Cardiovascular comorbidities were associated with increased levels. Levels consistently correlated with pulmonary artery pressure and left ventricular ejection fraction, but not pulmonary function or oxygen saturation. NP demonstrated high negative predictive values (0.80 to 0.98) to exclude left ventricular dysfunction in both stable and exacerbation of COPD, but relatively low positive predictive values. NP elevation predicted early adverse outcomes, but the association with long term mortality was inconsistent.ConclusionNP reflect diverse aspects of the cardiopulmonary continuum which limits utility when applied in isolation. Strategies integrating NP with additional variables, biomarkers and imaging require further investigation.

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Valor pronóstico del NT-proBNP en pacientes con enfermedad pulmonar crónica reagudizada

Cited by 3 publications

References 17 publications

Differential prognostic utility of NTproBNP and Cystatin C in patients with acute exacerbation of chronic pulmonary disease

Differential prognostic utility of NTproBNP and Cystatin C in patients with acute exacerbation of chronic pulmonary disease

Péptidos natriuréticos: ¿nuevas indicaciones?

B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

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