Publicação
Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes?
| Resumo: | BACKGROUND: NT-proBNP has prognostic implications in heart failure. In acute coronary syndromes (ACS) setting, the prognostic significance of NT-proBNP is being sought. We studied short-term prognostic impact of admission NT-proBNP in patients admitted for ACS and in association with GRACE risk score (GRS). METHODS AND RESULTS: We studied 1035 patients admitted with ACS. Patients were divided in quartiles according to NT-proBNP levels on admission: Q1 <180 pg/ml; Q2 180-691 pg/ml; Q3 696-2664 pg/ml; Q4 2698-35 000 pg/ml. Groups were compared in terms of short-term all-cause mortality. Patients with higher NT-proBNP had worst GRS on admission. They also received less aggressive treatment. In-hospital mortality was 0.8%, 3.0%, 5.8% and 12.8% (P<0.001) and 30-day mortality 1.6%, 4.6%, 6.5% and 16.7% (P<0.001) respectively. In multivariate logistic regression analysis, NT-proBNP is an independent predictor of in-hospital (OR 2.35; 95% CI: 1.12-4.93, P=0.022) and 30-day mortality (OR 2.20; 95% CI: 1.17-4.12, P=0.014). However, NT-proBNP does not add any incremental benefit to GRS for prediction of outcome by ROC curve analysis. CONCLUSIONS: NT-proBNP is an independent predictor of in-hospital and 30-day mortality after ACS, independently of left ventricular function, but does not increase the prognostic accuracy of GRS. |
|---|---|
| Autores principais: | Timóteo, AT |
| Outros Autores: | Toste, A; Ramos, R; Miranda, F; Ferreira, ML; Oliveira, JA; Cruz Ferreira, R |
| Assunto: | Analysis of Variance Biomarkers/blood Chi-Square Distribution Female Humans Linear Models Logistic Models Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain/blood Peptide Fragments/blood Portugal/epidemiology Predictive Value of Tests Prognosis ROC Curve Retrospective Studies Risk Assessment/methods Risk Factors Severity of Illness Index Statistics, Nonparametric Ventricular Dysfunction, Left/etiology Acute Coronary Syndrome/blood Hospital Mortality Patient Admission HSM CAR HSM PAT CLIN Acute Coronary Syndrome/complications Acute Coronary Syndrome/diagnosis Acute Coronary Syndrome/mortality |
| Ano: | 2009 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| Idioma: | inglês |
| Origem: | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| _version_ | 1877769693312319488 |
|---|---|
| author | Timóteo, AT |
| author2 | Toste, A Ramos, R Miranda, F Ferreira, ML Oliveira, JA Cruz Ferreira, R |
| author2_role | author author author author author author |
| author_facet | Timóteo, AT Toste, A Ramos, R Miranda, F Ferreira, ML Oliveira, JA Cruz Ferreira, R |
| author_role | author |
| contributor_name_str_mv | Repositório da Unidade Local de Saúde São José |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Timóteo, AT\"},{\"Person.name\":\"Toste, A\"},{\"Person.name\":\"Ramos, R\"},{\"Person.name\":\"Miranda, F\"},{\"Person.name\":\"Ferreira, ML\"},{\"Person.name\":\"Oliveira, JA\"},{\"Person.name\":\"Cruz Ferreira, R\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório da Unidade Local de Saúde São José |
| datacite.creators.creator.creatorName.fl_str_mv | Timóteo, AT Toste, A Ramos, R Miranda, F Ferreira, ML Oliveira, JA Cruz Ferreira, R |
| datacite.date.Accepted.fl_str_mv | 2009-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2017-04-19T09:34:54Z |
| datacite.date.embargoed.fl_str_mv | 2017-04-19T09:34:54Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Analysis of Variance Biomarkers/blood Chi-Square Distribution Female Humans Linear Models Logistic Models Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain/blood Peptide Fragments/blood Portugal/epidemiology Predictive Value of Tests Prognosis ROC Curve Retrospective Studies Risk Assessment/methods Risk Factors Severity of Illness Index Statistics, Nonparametric Ventricular Dysfunction, Left/etiology Acute Coronary Syndrome/blood Hospital Mortality Patient Admission HSM CAR HSM PAT CLIN Acute Coronary Syndrome/complications Acute Coronary Syndrome/diagnosis Acute Coronary Syndrome/mortality |
| datacite.titles.title.fl_str_mv | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| dc.contributor.none.fl_str_mv | Repositório da Unidade Local de Saúde São José |
| dc.creator.none.fl_str_mv | Timóteo, AT Toste, A Ramos, R Miranda, F Ferreira, ML Oliveira, JA Cruz Ferreira, R |
| dc.date.Accepted.fl_str_mv | 2009-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2017-04-19T09:34:54Z |
| dc.date.embargoed.fl_str_mv | 2017-04-19T09:34:54Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.17/2672 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Informa Healthcare |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Analysis of Variance Biomarkers/blood Chi-Square Distribution Female Humans Linear Models Logistic Models Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain/blood Peptide Fragments/blood Portugal/epidemiology Predictive Value of Tests Prognosis ROC Curve Retrospective Studies Risk Assessment/methods Risk Factors Severity of Illness Index Statistics, Nonparametric Ventricular Dysfunction, Left/etiology Acute Coronary Syndrome/blood Hospital Mortality Patient Admission HSM CAR HSM PAT CLIN Acute Coronary Syndrome/complications Acute Coronary Syndrome/diagnosis Acute Coronary Syndrome/mortality |
| dc.title.fl_str_mv | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | BACKGROUND: NT-proBNP has prognostic implications in heart failure. In acute coronary syndromes (ACS) setting, the prognostic significance of NT-proBNP is being sought. We studied short-term prognostic impact of admission NT-proBNP in patients admitted for ACS and in association with GRACE risk score (GRS). METHODS AND RESULTS: We studied 1035 patients admitted with ACS. Patients were divided in quartiles according to NT-proBNP levels on admission: Q1 <180 pg/ml; Q2 180-691 pg/ml; Q3 696-2664 pg/ml; Q4 2698-35 000 pg/ml. Groups were compared in terms of short-term all-cause mortality. Patients with higher NT-proBNP had worst GRS on admission. They also received less aggressive treatment. In-hospital mortality was 0.8%, 3.0%, 5.8% and 12.8% (P<0.001) and 30-day mortality 1.6%, 4.6%, 6.5% and 16.7% (P<0.001) respectively. In multivariate logistic regression analysis, NT-proBNP is an independent predictor of in-hospital (OR 2.35; 95% CI: 1.12-4.93, P=0.022) and 30-day mortality (OR 2.20; 95% CI: 1.17-4.12, P=0.014). However, NT-proBNP does not add any incremental benefit to GRS for prediction of outcome by ROC curve analysis. CONCLUSIONS: NT-proBNP is an independent predictor of in-hospital and 30-day mortality after ACS, independently of left ventricular function, but does not increase the prognostic accuracy of GRS. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.chlc.pt/bitstreams/85861e9c-6cc3-426e-ae21-1cc5074ae48a/download |
| id | rchlc_634cd6b19ce8cc17292029efc7fe1d46 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10400.17/2672 |
| inst_facet_str | urn:organizationAcronym:chlc{{{_:::_}}}Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| instacron_str | chlc |
| institution | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| instname_str | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| language | eng |
| network_acronym_str | rchlc |
| network_name_str | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| oai_identifier_str | oai:repositorio.chlc.pt:10400.17/2672 |
| organization_str_mv | urn:organizationAcronym:chlc |
| person_str_mv | Timóteo, AT Toste, A Ramos, R Miranda, F Ferreira, ML Oliveira, JA Cruz Ferreira, R |
| publishDate | 2009 |
| publisher.none.fl_str_mv | Informa Healthcare |
| repo_facet_str | urn:repositoryAcronym:rchlc{{{_:::_}}}Repositório do Centro Hospitalar de Lisboa Central, EPE |
| reponame_str | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| repository_id_str | urn:repositoryAcronym:rchlc |
| service_str_mv | urn:repositoryAcronym:rchlc |
| spelling | engInforma Healthcarept_PTBACKGROUND: NT-proBNP has prognostic implications in heart failure. In acute coronary syndromes (ACS) setting, the prognostic significance of NT-proBNP is being sought. We studied short-term prognostic impact of admission NT-proBNP in patients admitted for ACS and in association with GRACE risk score (GRS). METHODS AND RESULTS: We studied 1035 patients admitted with ACS. Patients were divided in quartiles according to NT-proBNP levels on admission: Q1 <180 pg/ml; Q2 180-691 pg/ml; Q3 696-2664 pg/ml; Q4 2698-35 000 pg/ml. Groups were compared in terms of short-term all-cause mortality. Patients with higher NT-proBNP had worst GRS on admission. They also received less aggressive treatment. In-hospital mortality was 0.8%, 3.0%, 5.8% and 12.8% (P<0.001) and 30-day mortality 1.6%, 4.6%, 6.5% and 16.7% (P<0.001) respectively. In multivariate logistic regression analysis, NT-proBNP is an independent predictor of in-hospital (OR 2.35; 95% CI: 1.12-4.93, P=0.022) and 30-day mortality (OR 2.20; 95% CI: 1.17-4.12, P=0.014). However, NT-proBNP does not add any incremental benefit to GRS for prediction of outcome by ROC curve analysis. CONCLUSIONS: NT-proBNP is an independent predictor of in-hospital and 30-day mortality after ACS, independently of left ventricular function, but does not increase the prognostic accuracy of GRS.application/pdfpt_PTDoes Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes?Timóteo, ATToste, ARamos, RMiranda, FFerreira, MLOliveira, JACruz Ferreira, RHostingInstitutionOrganizationalRepositório da Unidade Local de Saúde São Josée-mailmailto:repositorio@ulssjose.min-saude.ptrepositorio@ulssjose.min-saude.ptDOIIsPartOf10.1080/174829409031770362017-04-19T09:34:54Z20092009-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.17/2672http://purl.org/coar/access_right/c_abf2open accessAnalysis of VarianceBiomarkers/bloodChi-Square DistributionFemaleHumansLinear ModelsLogistic ModelsMaleMiddle AgedMultivariate AnalysisNatriuretic Peptide, Brain/bloodPeptide Fragments/bloodPortugal/epidemiologyPredictive Value of TestsPrognosisROC CurveRetrospective StudiesRisk Assessment/methodsRisk FactorsSeverity of Illness IndexStatistics, NonparametricVentricular Dysfunction, Left/etiologyAcute Coronary Syndrome/bloodHospital MortalityPatient AdmissionHSM CARHSM PAT CLINAcute Coronary Syndrome/complicationsAcute Coronary Syndrome/diagnosisAcute Coronary Syndrome/mortality149047 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.chlc.pt/bitstreams/85861e9c-6cc3-426e-ae21-1cc5074ae48a/downloadAcute Cardiac Care114236242 |
| spellingShingle | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? Timóteo, AT Analysis of Variance Biomarkers/blood Chi-Square Distribution Female Humans Linear Models Logistic Models Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain/blood Peptide Fragments/blood Portugal/epidemiology Predictive Value of Tests Prognosis ROC Curve Retrospective Studies Risk Assessment/methods Risk Factors Severity of Illness Index Statistics, Nonparametric Ventricular Dysfunction, Left/etiology Acute Coronary Syndrome/blood Hospital Mortality Patient Admission HSM CAR HSM PAT CLIN Acute Coronary Syndrome/complications Acute Coronary Syndrome/diagnosis Acute Coronary Syndrome/mortality |
| status | SINGLETON |
| subject.fl_str_mv | Analysis of Variance Biomarkers/blood Chi-Square Distribution Female Humans Linear Models Logistic Models Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain/blood Peptide Fragments/blood Portugal/epidemiology Predictive Value of Tests Prognosis ROC Curve Retrospective Studies Risk Assessment/methods Risk Factors Severity of Illness Index Statistics, Nonparametric Ventricular Dysfunction, Left/etiology Acute Coronary Syndrome/blood Hospital Mortality Patient Admission HSM CAR HSM PAT CLIN Acute Coronary Syndrome/complications Acute Coronary Syndrome/diagnosis Acute Coronary Syndrome/mortality |
| title | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| title_full | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| title_fullStr | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| title_full_unstemmed | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| title_short | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| title_sort | Does Admission NT-ProBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-Term Mortality After Acute Coronary Syndromes? |
| topic | Analysis of Variance Biomarkers/blood Chi-Square Distribution Female Humans Linear Models Logistic Models Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain/blood Peptide Fragments/blood Portugal/epidemiology Predictive Value of Tests Prognosis ROC Curve Retrospective Studies Risk Assessment/methods Risk Factors Severity of Illness Index Statistics, Nonparametric Ventricular Dysfunction, Left/etiology Acute Coronary Syndrome/blood Hospital Mortality Patient Admission HSM CAR HSM PAT CLIN Acute Coronary Syndrome/complications Acute Coronary Syndrome/diagnosis Acute Coronary Syndrome/mortality |
| topic_facet | Analysis of Variance Biomarkers/blood Chi-Square Distribution Female Humans Linear Models Logistic Models Male Middle Aged Multivariate Analysis Natriuretic Peptide, Brain/blood Peptide Fragments/blood Portugal/epidemiology Predictive Value of Tests Prognosis ROC Curve Retrospective Studies Risk Assessment/methods Risk Factors Severity of Illness Index Statistics, Nonparametric Ventricular Dysfunction, Left/etiology Acute Coronary Syndrome/blood Hospital Mortality Patient Admission HSM CAR HSM PAT CLIN Acute Coronary Syndrome/complications Acute Coronary Syndrome/diagnosis Acute Coronary Syndrome/mortality |
| url | http://hdl.handle.net/10400.17/2672 |
| visible | 1 |
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