Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS)...
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doaj-526a0e5d530b4a79b6ce849d73de7c822021-04-13T23:02:25ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01101653165310.3390/jcm10081653Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary SyndromeAlberto Cordero0Elías Martínez Rey-Rañal1María J. Moreno2David Escribano3José Moreno-Arribas4Maria A. Quintanilla5Pilar Zuazola6Julio Núñez7Vicente Bertomeu-González8Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainCardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainCardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainCardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainCardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainCardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainCardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226-CB16/11/00420), 28028 Madrid, SpainCardiology Department, Hospital Universitario de San Juan, 03550 Alicante, SpainBackground: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). Results: Of the 2133 included patients, 528 (24.8%) had HF during the ACS hospitalization, and their pro-BNP levels were higher (3220 pg/mL vs. 684.2 pg/mL; <i>p</i> < 0.001). In-hospital mortality was 2.9%, and pro-BNP was similarly higher in these patients. Increased pro-BNP levels were correlated to increased risk of HF or death during the hospitalization. Over follow-up (median 38 months) 243 (11.7%) patients had at least one hospital readmission for HF and 151 (7.1%) had more than one. Complete revascularization had a preventive effect on HF readmission, whereas several other variables were associated with higher risk. Pro-BNP was independently associated with HF admission (sHR: 1.47) and readmission (IRR: 1.45) at any age. Significant interactions were found for the predictive value of pro-BNP in women, diabetes, renal dysfunction, STEMI and patients without troponin elevation. Conclusions: In-hospital determination of pro-BNP is an independent predictor of HF readmission after an ACS.https://www.mdpi.com/2077-0383/10/8/1653pro-BNPheart failureacute coronary syndrome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alberto Cordero Elías Martínez Rey-Rañal María J. Moreno David Escribano José Moreno-Arribas Maria A. Quintanilla Pilar Zuazola Julio Núñez Vicente Bertomeu-González |
spellingShingle |
Alberto Cordero Elías Martínez Rey-Rañal María J. Moreno David Escribano José Moreno-Arribas Maria A. Quintanilla Pilar Zuazola Julio Núñez Vicente Bertomeu-González Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome Journal of Clinical Medicine pro-BNP heart failure acute coronary syndrome |
author_facet |
Alberto Cordero Elías Martínez Rey-Rañal María J. Moreno David Escribano José Moreno-Arribas Maria A. Quintanilla Pilar Zuazola Julio Núñez Vicente Bertomeu-González |
author_sort |
Alberto Cordero |
title |
Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome |
title_short |
Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome |
title_full |
Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome |
title_fullStr |
Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome |
title_full_unstemmed |
Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome |
title_sort |
predictive value of pro-bnp for heart failure readmission after an acute coronary syndrome |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-04-01 |
description |
Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). Results: Of the 2133 included patients, 528 (24.8%) had HF during the ACS hospitalization, and their pro-BNP levels were higher (3220 pg/mL vs. 684.2 pg/mL; <i>p</i> < 0.001). In-hospital mortality was 2.9%, and pro-BNP was similarly higher in these patients. Increased pro-BNP levels were correlated to increased risk of HF or death during the hospitalization. Over follow-up (median 38 months) 243 (11.7%) patients had at least one hospital readmission for HF and 151 (7.1%) had more than one. Complete revascularization had a preventive effect on HF readmission, whereas several other variables were associated with higher risk. Pro-BNP was independently associated with HF admission (sHR: 1.47) and readmission (IRR: 1.45) at any age. Significant interactions were found for the predictive value of pro-BNP in women, diabetes, renal dysfunction, STEMI and patients without troponin elevation. Conclusions: In-hospital determination of pro-BNP is an independent predictor of HF readmission after an ACS. |
topic |
pro-BNP heart failure acute coronary syndrome |
url |
https://www.mdpi.com/2077-0383/10/8/1653 |
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