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

J 2019

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

ŠPINAR, Jindřich, Lenka ŠPINAROVÁ, Filip MALEK, Ondřej LUDKA, Jan KREJČÍ et. al.

Basic information

Original name

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

Authors

ŠPINAR, Jindřich (203 Czech Republic, belonging to the institution), Lenka ŠPINAROVÁ (203 Czech Republic, belonging to the institution), Filip MALEK (203 Czech Republic), Ondřej LUDKA (203 Czech Republic, belonging to the institution), Jan KREJČÍ (203 Czech Republic, belonging to the institution), Petr OSTADAL (203 Czech Republic), Dagmar VONDRAKOVA (203 Czech Republic), Karel LÁBR (203 Czech Republic, belonging to the institution), Monika ŠPINAROVÁ (203 Czech Republic, belonging to the institution), Monika PÁVKOVÁ GOLDBERGOVÁ (203 Czech Republic, belonging to the institution), Klára BENEŠOVÁ (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, guarantor, belonging to the institution) and Jiří PAŘENICA (203 Czech Republic, belonging to the institution)

Edition

Plos one, San Francisco, Public Library of Science, 2019, 1932-6203

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.740

RIV identification code

RIV/00216224:14110/19:00109546

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1371/journal.pone.0214363

UT WoS

000462305600050

Keywords in English

chronic heart failure

Abstract

V originále

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.

Links

MUNI/A/1250/2017, interní kód MU

Name: Validace Rule-out/rule-in protokolu u pacientů s bolestí na hrudi – pokračování v prospektivní studii

Investor: Masaryk University, Category A

Citovat

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. 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.

@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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