Key result
High circulating concentrations of NT pro-BNP (HR 2.217) and hs-CRP (HR 1.922) at admission were independent predictors of all-cause mortality in hospitalized patients with dilated cardiomyopathy.
Why the study?
Do elevated admission levels of NT pro-BNP, hs-CRP, and big-ET predict all-cause mortality in hospitalized patients with dilated cardiomyopathy?
Cohort (n=622)
No
Do elevated admission levels of NT pro-BNP, hs-CRP, and big-ET predict all-cause mortality in hospitalized patients with dilated cardiomyopathy?
Effect estimate: HR 2.217 (95% CI 1.015-4.846)
Absolute Event Rate: 34.8% vs 11.9%
p-value: p=0.046
Elevated admission levels of NT pro-BNP and hs-CRP, but not big-ET, are independent predictors of all-cause mortality in hospitalized patients with dilated cardiomyopathy.
May aid admission risk stratification in dilated cardiomyopathy; extends prior biomarker data but remains hypothesis-generating.
BACKGROUND: Circulating N-terminal pro-B-type natriuretic peptide (NT pro-BNP), high- sensitivity C-reactive protein (hs-CRP) and big endothelin (big-ET) have been shown to be increased in heart failure and to contribute to both hemodynamic deterioration and cardiovascular remodeling. Here, we examined the prognostic value of the three neurohormones at admission in a population of hospitalized patients with dilated cardiomyopathy (DCM). METHODS AND RESULTS: This cohort study was undertaken in 622 hospitalized patients with DCM in Fuwai Hospital from January 2005 to September 2011 (female 26.5%, 51.4 ± 14.6 years old). Standard demographics, echocardiography and routine blood samples were obtained shortly after admission. NT pro-BNP, hs-CRP and big-ET were measured, and their concentrations in relation to all-cause mortality were assessed through a mean follow-up of 2.6 ± 1.6 years. Kaplan-Meier curves showed that the all-cause mortality rates were higher in patients with NT pro-BNP > 2247 pmol/L compared to patients with NT pro-BNP < 2247 pmol/L (11.9% vs 34.8%, log-rank χ2 = 35.588, P < 0.001), in patients with hs-CRP > 3.90 mg/L compared to patients with hs-CRP < 3.90 mg/L (12.8% vs 33.6%, log-rank χ2 = 39.662, P < 0.001) and in patients with big-ET > 0.95 pmol/L compared to patients with big-ET <0.95 pmol/L (12.5% vs 31.0%, log-rank χ2 = 17.890, P < 0.001). High circulating concentrations of NT pro-BNP (HR 2.217, 95% CI 1.015-4.846, P = 0.046) and hs-CRP (HR 1.922, 95% CI 1.236-2.988, P = 0.004), but not big-ET, in addition to left atrial diameter and fasting blood glucose, were independent predictors of the outcome defined as all-cause mortality. CONCLUSIONS: In a large population of patients with DCM, the circulating concentrations of NT pro-BNP and hs-CRP, but not big-ET, were independent markers of all-cause mortality.
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Li et al. (2014) conducted a cohort in Dilated cardiomyopathy (n=622). High NT pro-BNP (> 2247 pmol/L) vs. Low NT pro-BNP (< 2247 pmol/L) was evaluated on All-cause mortality (HR 2.217, 95% CI 1.015-4.846, p=0.046). High circulating concentrations of NT pro-BNP (HR 2.217) and hs-CRP (HR 1.922) at admission were independent predictors of all-cause mortality in hospitalized patients with dilated cardiomyopathy.
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