Your browser doesn't support javascript.
loading
Early identification of acute heart failure at the time of presentation: do natriuretic peptides make the difference?
Möckel, Martin; von Haehling, Stephan; Vollert, Jörn O; Wiemer, Jan C; Anker, Stefan D; Maisel, Alan.
Afiliación
  • Möckel M; Division of Emergency and Acute Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
  • von Haehling S; Department of Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
  • Vollert JO; Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.
  • Wiemer JC; BRAHMS, Thermo Fisher Scientific, Hennigsdorf, Germany.
  • Anker SD; BRAHMS, Thermo Fisher Scientific, Hennigsdorf, Germany.
  • Maisel A; Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.
ESC Heart Fail ; 5(3): 309-315, 2018 06.
Article en En | MEDLINE | ID: mdl-29667356
BACKGROUND: The early identification of patients with acute heart failure (AHF) is challenging as many other diseases lead to a clinical presentation with dyspnea. AIM: The aim of the study was to evaluate the impact of natriuretic peptides at common HF study cut-offs on the diagnosis of patients with dyspnea at admission. METHODS AND RESULTS: For this post hoc analysis, we analysed n = 726 European Union (EU) patients from the prospective BACH (Biomarkers in Acute Heart Failure) study. Cut-offs were 350 ng/L (BNP), 300 pmol/L [pro-atrial natriuretic peptide (proANP)], and 1800 ng/L (NT-proBNP). These cut-offs had equivalent 90 days' mortality in the EU cohort of BACH. We analysed the effect of selection using these cut-offs on the prevalence of the gold standard diagnoses made in the BACH study and the respective mortality. The prevalence of AHF is increased from 47.5 to 75.6% (NT-proBNP criteria) up to 79.7% (BNP criteria). With the use of the proANP criteria, 90 days' mortality of patients with AHF rose from 14 to 17% (P = 0.029). In the group with no-AHF diagnoses, mortality rose from 10 to 25% (P < 0.001). CONCLUSIONS: The prevalence of patients with the gold standard diagnoses of AHF among those presenting with dyspnea to the emergency department is significantly increased by the use of natriuretic peptides with common cut-offs used in prospective HF studies. Nevertheless, in the selected groups, patients with no AHF diagnosis have the highest mortality, and therefore, the addition of a natriuretic peptide alone is insufficient to start specific therapies.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fragmentos de Péptidos / Medición de Riesgo / Péptido Natriurético Encefálico / Diagnóstico Precoz / Insuficiencia Cardíaca Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: ESC Heart Fail Año: 2018 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fragmentos de Péptidos / Medición de Riesgo / Péptido Natriurético Encefálico / Diagnóstico Precoz / Insuficiencia Cardíaca Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: ESC Heart Fail Año: 2018 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido