The Predictive Value of NT-Pro-Brain Natriuretic Peptide for Risk of Pneumonia in Patients on Maintenance Hemodialysis

2020 ◽  
Vol 49 (3) ◽  
pp. 348-355
Author(s):  
Man Guo ◽  
Xuesen Cao ◽  
Bo Shen ◽  
Xuemei Geng ◽  
Rongyi Chen ◽  
...  
Keyword(s):  
Prospective Study ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Treatment And Prevention ◽  
History Of

Background/Aims: Pneumonia is a common type of infection in maintenance hemodialysis (MHD) patients, while the treatment and prevention progress still keep limited. N-terminal-pro-brain natriuretic peptide (NT-proBNP) is an important marker in reflecting cardiac failure which also is a risk factor for pneumonia. This study aimed to determine the possible predictive value of NT-proBNP for pneumonia in MHD patients. Methods: In this prospective study, the basic information of 276 MHD patients was collected in Fudan university Zhongshan hospital, followed up for 1 year. The primary endpoint was the first pneumonia event during follow-up. The value of NT-proBNP in patients with pneumonia and without pneumonia was analyzed, to elucidate the predictive value of the NT-proBNP in hemodialysis patients with pneumonia. Results: Two hundred and seventy-six patients were finally enrolled in this prospective study, including 170 men. The mean age was 59.7 ± 14.0 years old. The average duration of hemodialysis is 56 (30–82.8) months. Enrolled patients were followed up for 1 year. During follow-up, 38 patients got pneumonia. After adjustment for other confounding factors, age (hazard ratio [HR] 1.031, 95% CI 1.003–1.060, p = 0.028), log NT-proBNP (HR 2.512, 95% CI 1.124–5.612, p = 0.025), history of smoking (HR 6.326, 95% CI 2.505–15.974, p < 0.001), β2-microglobin (HR 1.042, 95% CI 1.007–1.079, p = 0.019), and history of cerebrovascular disease (HR 2.303, 95% CI 1.107–4.719, p = 0.026) were independent predictors of pneumonia. Receiver operating characteristic curves of log NT-proBNP to predict 1 year pneumonia cases, log NT-proBNP had an area under the curve of 0.647 (95% CI [0.564–0.729], p < 0.01). Conclusions: NT-proBNP is a predictive factor of pneumonia in hemodialysis patients.

Brain Natriuretic Peptide between Traditional and Nontraditional Risk Factors in Hemodialysis Patients: Analysis of Cardiovascular Mortality in a Two-Year Follow-Up

2011 ◽  
Vol 119 (2) ◽  
pp. c162-c170 ◽  
Author(s):  
G. Selim ◽  
O. Stojceva-Taneva ◽  
G. Spasovski ◽  
L. Georgievska-Ismail ◽  
B. Zafirovska-Ivanovska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiovascular Mortality ◽  
Hemodialysis Patients

scholarly journals Association of N-Terminal Pro-brain Natriuretic Peptide With Volume Status and Cardiac Function in Hemodialysis Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Yaqiong Wang ◽  
Xuesen Cao ◽  
Jinbo Yu ◽  
Yongmei Zhang ◽  
Xianzhe Li ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Area Under The Curve ◽  
Volume Overload ◽  
Hemodialysis Patients ◽  
Receiver Operating Characteristic Curves ◽  
Confounding Variables ◽  
Structure Disorder ◽  
The Relationship ◽  
Hemodialysis Duration

Introduction: N-terminal-pro-brain natriuretic peptide (NT-pro BNP) is secreted by cardiomyocytes in cases of cardiac structure disorder and volume overload. However, the relationship between NT-pro BNP level and body fluid status in dialysis patients with reduced cardiac ejection function (EF) is uncertain. Therefore, we aimed to investigate this relationship.Methods: We enrolled patients who had been receiving hemodialysis for &gt;3 months. Blood sample, transthoracic echocardiographic, and bioimpedance spectroscopy measurements were performed during a midweek non-dialysis day. The predictive value of NT-pro BNP in hemodialysis patients with volume overload was analyzed.Results: A total of 129 hemodialysis patients (74 men and 55 women; mean age: 59.4 ± 13.0 years) were recruited. The average hemodialysis duration was 55.5 (23.9–93.4) months, the NT-pro BNP level was 4992 (2,033–15,807) pg/mL, and the value of overhydration was 2.68 ± 0.19 (−1.9 to 12.2) L. The NT-pro BNP level was independently correlated with overhydration in both the LVEF ≥ 60% (β = 0.236, P = 0.044) and LVEF &lt;60% (β = 0.516, P = 0.032) groups, even after adjustments for potentially confounding variables. In receiver operating characteristic curves of NT-pro BNP for predicting volume overload, the area under the curve was 0.783 [95% CI (0.688–0.879), P &lt; 0.001) and 0.788 [95% CI (0.586–0.989), P &lt; 0.001] in the LVEF ≥ 60% and LVEF &lt; 60% groups, respectively.Conclusions: NT-pro BNP is a predictive factor for volume overload in hemodialysis patients with or without EF declines.

Brain Natriuretic Peptide in Hemodialysis Patients: Predictive Value for Hemodynamic Change during Hemodialysis and Cardiac Function

2007 ◽  
Vol 28 (1) ◽  
pp. 122-127 ◽  
Author(s):  
Tetsutaro Matayoshi ◽  
Toako Kato ◽  
Hajime Nakahama ◽  
Hiroto Nakata ◽  
Fumiki Yoshihara ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
Hemodialysis Patients ◽  
Hemodynamic Change

scholarly journals The Predictive Value of Plasma Brain Natriuretic Peptide and Galectin-3 in Elderly Patients Admitted for Heart Failure

Diseases ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 88 ◽  
Author(s):  
Marzia Testa ◽  
Gian Rosso ◽  
Cinzia Ferreri ◽  
Mauro Feola
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
Kaplan Meier ◽  
Galectin 3 ◽  
Independent Marker

Galectin-3 is demonstrated to be a robust independent marker of cardiovascular mid-term (18-month) outcomes in heart failure (HF) patients. The aim of this study was to analyze the value of a pre-discharged determination of galectin-3 alone and with brain natriuretic peptide (BNP) in predicting mid-term outcomes in elderly patients (>70 years old) discharged after an acute decompensated HF (ADHF) episode. Methods: all elderly (≥70 years old) HF subjects discharged alive after an ADHF were enrolled. All patients underwent a determination of BNP and galectin-3, a 6-min walking test (6MWT), and an echocardiogram within 48 h of hospital discharge. Cardiac death, cardiac transplantation, and worsening heart failure requiring readmission to hospital were considered cardiovascular events. Results: 84 patients (63 males (75%), age 77.5 ± 5.9 years old) were analyzed (mean follow-up: 16.2 ± 12.3 months). During the follow-up, 45 events (53.6%) were scheduled (18 cardiac deaths, 27 re-hospitalizations for ADHF). HF patients who suffered an event demonstrated more impaired ventricular function (p = 0.04), higher value of BNP (p = 0.02), and Gal-3 at a pre-discharge evaluation (p = 0.05). By choosing adequate cut-off points (BNP ≥ 500 pg/mL and Gal-3 ≥ 17.6 ng/mL), the Kaplan–Meier curves depicted a powerful stratification using Galectin-3 > 17.6 ng/mL alone (log-rank 13.22; p = 0.0003), and by adding BNP + Gal-3, an even better result was obtained (log-rank 17.96; p < 0.00001). Conclusion: in an elderly population, by adding Gal-3 to BNP, a single pre-discharge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode.

scholarly journals Association of Brain Natriuretic Peptide With Mortality in Exceptionally Long-Lived Families

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 211-211
Author(s):  
Allison Kuipers ◽  
Robert Boudreau ◽  
Mary Feitosa ◽  
Angeline Galvin ◽  
Bharat Thygarajan ◽  
...  
Keyword(s):  
Older Adults ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Sex Education ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Time To Event ◽  
Healthy Older Adults ◽  
Secondary Analyses

Abstract Natriuretic peptides are produced within the heart and released in response to increased chamber wall tension and heart failure (HF). N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) is a specific natriuretic peptide commonly assayed in persons at risk for HF. In these individuals, NT-proBNP is associated with future disease prognosis and mortality. However, its association with mortality among healthy older adults remains unknown. Therefore, we determined the association of NT-proBNP with all-cause mortality over a median follow-up of 10 years in 3253 individuals free from HF at baseline in the Long Life Family Study, a study of families recruited for exceptional longevity. We performed cox proportional hazards analysis (coxme in R) for time-to event (mortality), adjusted for field center, familial relatedness, age, sex, education, smoking, alcohol, physical activity, BMI, diabetes, hypertension, and cancer. In addition, we performed secondary analyses among individuals (N=2457) within the normal NT-proBNP limits at baseline (&lt;125pg/ml aged &lt;75 years; &lt;450pg/ml aged ≥75 years). Overall, individuals were aged 32-110 years (median 67 years; 44% male), had mean NT-proBNP of 318.5 pg/ml (median 91.0 pg/ml) and 1066 individuals (33%) died over the follow-up period. After adjustment, each 1 SD greater baseline NT-proBNP was associated with a 1.30-times increased hazard of mortality (95% CI: 1.24-1.36; P&lt;0.0001). Results were similar in individuals with normal baseline NT-proBNP (HR: 1.21; 95% CI: 1.11-1.32; P&lt;0.0001). These results suggest that NT-proBNP is a strong and specific biomarker for mortality in older adults independent of current health status, even in those with clinically-defined normal NT-proBNP.

scholarly journals New screening approach to detecting congenital syphilis in China: a retrospective cohort study

2020 ◽  
pp. archdischild-2020-320549
Author(s):  
Fang Hu ◽  
Shuai-Jun Guo ◽  
Jian-Jun Lu ◽  
Ning-Xuan Hua ◽  
Yan-Yan Song ◽  
...  
Keyword(s):  
Predictive Value ◽  
Congenital Syphilis ◽  
Area Under The Curve ◽  
Diagnostic Tools ◽  
Operating Characteristics ◽  
Loss To Follow Up ◽  
Sensitivity Specificity ◽  
Mother To Child ◽  
Rule Out

BackgroundDiagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of non-treponemal antibody as predictors of CS.MethodsConfirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women.ResultsAmong 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cut-off value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cut-off value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cut-off value 1:32 and treatment before 28 GWs), respectively.ConclusionsAn algorithm using maternal non-treponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

Abstract 12849: Changes in N-terminal Pro Brain Natriuretic Peptide Levels Predicts Mortality and Heart Failure Hospitalization in Patients With Heart Failure and Preserved Ejection Fraction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Gianluigi Savarese ◽  
Camilla Hage ◽  
Ulf Dahlström ◽  
Pasquale Perrone-Filardi ◽  
Lars H Lund
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Total Mortality ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Impact

Introduction: Changes in N-terminal pro brain natriuretic peptide (NT-proBNP) have been demonstrated to correlate with outcomes in patients with heart failure (HF) and reduced ejection fraction (EF). However the prognostic value of a change in NT-proBNP in patients with heart failure and preserved ejection fraction (HFPEF) is unknown. Hypothesis: To assess the impact of changes in NT-proBNP on all-cause mortality, HF hospitalization and their composite in an unselected population of patients with HFPEF. Methods: 643 outpatients (age 72+12 years; 41% females) with HFPEF (ejection fraction ≥40%) enrolled in the Swedish Heart Failure Registry between 2005 and 2012 and reporting NT-proBNP levels assessment at initial registration and at follow-up were prospectively studied. Patients were divided into 2 groups according the median value of NT-proBNP absolute change that was 0 pg/ml. Median follow-up from first measurement was 2.25 years (IQR: 1.43 to 3.81). Adjusted Cox’s regression models were performed using total mortality, HF hospitalization (with censoring at death) and their composite as outcomes. Results: After adjustments for 19 baseline variables including baseline NT-proBNP, as compared with an increase in NT-proBNP levels at 6 months (NT-proBNP change>0 pg/ml), a reduction in NT-proBNP levels (NT-proBNP change<0 pg/ml) was associated with a 45.2% reduction in risk of all-cause death (HR: 0.548; 95% CI: 0.378 to 0.796; p:0.002), a 50.1% reduction in risk of HF hospitalization (HR: 0.49; 95% CI: 0.362 to 0.689; p<0.001) and a 42.6% reduction in risk of the composite outcome (HR: 0.574; 95% CI: 0.435 to 0.758; p<0.001)(Figure). Conclusions: Reductions in NT-proBNP levels over time are independently associated with an improved prognosis in HFPEF patients. Changes in NT-proBNP could represent a surrogate outcome in phase 2 HFPEF trials.

scholarly journals Outbreak of Foodborne Botulism in Alexandria, Egypt: Modulating Indications for Administration of Heptavalent Botulinum Antitoxin

2021 ◽  
Author(s):  
Sara A Ghitani ◽  
Maha A Ghanem ◽  
Eman A Sultan ◽  
Maram Atef ◽  
Maii F Henaidy
Keyword(s):  
Prospective Study ◽  
Clinical Characteristics ◽  
Personal Data ◽  
Poison Center ◽  
Supportive Treatment ◽  
Past Medical History ◽  
Salted Fish ◽  
History Of ◽  
Foodborne Botulism

Abstract Background: In October 2019, 94 patients were admitted into Alexandria Poison Center (APC) with a history of ingestion of Feseekh (salted fish). As a trial to allocate the resources, not all patients were given Heptavalent botulinum antitoxin (HBAT) immediately.The current study aimed to portray the clinical characteristics of the cases, explore the possible relation between these characteristics and necessity of HBAT administration, explore the reliability of MLT, and to establish a clinical guide for management with preservation of resources.Subject and Method: the current prospective study included 94 patients who were admitted to Alexandria Poison Center (APC) in the period from 29 th September to 27 th October 2019. The patients' data was recorded using a checklist that includes: personal data, past medical history, clinical assessment, investigations, treatment and the outcome. The checklist was carried out to assess and follow up each patient. Hospitalized patients were categorized according to symptoms consistent with botulism. The equine HBAT, made by Emergent BioSolutions Canada Inc. (formerly Can gene Corporation) was used in the treatment.Results: HBAT was given to (36.2%) patients only out of the total admission. However, 87.2% of patients were completely cured, whereas 10.6% of patients were discharged with mild neurological sequelea and death occurred only in two cases (2.2%).Conclusion: 63.8% of cases with suspected foodborne botulism toxicity could be managed by supportive treatment only with no need for HBAT.

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