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@article{1527049, author = {Špinar, Jindřich and Špinarová, Lenka and Malek, Filip and Ludka, Ondřej and Krejčí, Jan and Ostadal, Petr and Vondrakova, Dagmar and Lábr, Karel and Špinarová, Monika and Pávková Goldbergová, Monika and Benešová, Klára and Jarkovský, Jiří and Pařenica, Jiří}, article_location = {San Francisco}, article_number = {3}, doi = {http://dx.doi.org/10.1371/journal.pone.0214363}, keywords = {chronic heart failure}, language = {eng}, issn = {1932-6203}, journal = {Plos one}, title = {Prognostic value of NT-proBNP added to clinical parameters to predict two-year prognosis of chronic heart failure patients with mid-range and reduced ejection fraction - A report from FAR NHL prospective registry}, url = {http://dx.doi.org/10.1371/journal.pone.0214363}, volume = {14}, year = {2019} }
TY - JOUR ID - 1527049 AU - Špinar, Jindřich - Špinarová, Lenka - Malek, Filip - Ludka, Ondřej - Krejčí, Jan - Ostadal, Petr - Vondrakova, Dagmar - Lábr, Karel - Špinarová, Monika - Pávková Goldbergová, Monika - Benešová, Klára - Jarkovský, Jiří - Pařenica, Jiří PY - 2019 TI - Prognostic value of NT-proBNP added to clinical parameters to predict two-year prognosis of chronic heart failure patients with mid-range and reduced ejection fraction - A report from FAR NHL prospective registry JF - Plos one VL - 14 IS - 3 SP - 1-15 EP - 1-15 PB - Public Library of Science SN - 19326203 KW - chronic heart failure UR - http://dx.doi.org/10.1371/journal.pone.0214363 L2 - http://dx.doi.org/10.1371/journal.pone.0214363 N2 - Background According to guidelines, the prognosis of patients with chronic heart failure can be predicted by determining the levels of natriuretic peptides, the NYHA classification and comorbidities. The aim our work was to develop a prognostic score in chronic heart failure patients that would take account of patients' comorbidities, NYHA and NT-proBNP levels. Methods and results A total of 1,088 patients with chronic heart failure with reduced ejection fraction (HFrEF) (LVEF<40%) and mid-range EF (HFmrEF) (LVEF 40-49%) were enrolled consecutively. Two-year all-cause mortality, heart transplantation and/or LVAD implantation were defined as the primary endpoint (EP). The occurrence of EP was 14.9% and grew with higher NYHA, namely 4.9% (NYHA I), 11.4% (NYHA II) and 27.8% (NYHA III-IV) (p<0.001). The occurrence of EP was 3%, 10% and 15-37% in patients with NT-proBNP levels <= 125 ng/L, 126-1000 ng/L and >1000 ng/L respectively. Discrimination abilities of NYHA and NT-proBNP were AUC 0.670 (p<0.001) and AUC 0.722 (p<0.001) respectively. The predictive value of the developed clinical model, which took account of older age, advanced heart failure (NYHA III+IV), anaemia, hyponatraemia, hyperuricaemia and being on a higher dose of furosemide (>40 mg daily) (AUC 0.773; p<0.001) was increased by adding the NT-proBNP level (AUC 0.790). Conclusion The use of prediction models in patients with chronic heart failure, namely those taking account of natriuretic peptides, should become a standard in routine clinical practice. It might contribute to a better identification of a high-risk group of patients in which more intense treatment needs to be considered, such as heart transplantation or LVAD implantation. ER -
ŠPINAR, Jindřich, Lenka ŠPINAROVÁ, Filip MALEK, Ondřej LUDKA, Jan KREJČÍ, Petr OSTADAL, Dagmar VONDRAKOVA, Karel LÁBR, Monika ŠPINAROVÁ, Monika PÁVKOVÁ GOLDBERGOVÁ, Klára BENEŠOVÁ, Jiří JARKOVSKÝ and Jiří PAŘENICA. Prognostic value of NT-proBNP added to clinical parameters to predict two-year prognosis of chronic heart failure patients with mid-range and reduced ejection fraction - A report from FAR NHL prospective registry. \textit{Plos one}. San Francisco: Public Library of Science, 2019, vol.~14, No~3, p.~1-15. ISSN~1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0214363.
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