Key result
Predischarge BNP levels ≥500 pg/mL significantly predicted 6-month death or heart failure readmission in elderly patients with cardiogenic pulmonary edema compared to ≤200 pg/mL (HR 3.6233; p=0.0009).
Why the study?
Do predischarge B-type natriuretic peptide (BNP) levels predict death or heart failure readmission in elderly patients admitted for cardiogenic pulmonary edema?
Cohort (n=203)
Do predischarge B-type natriuretic peptide (BNP) levels predict death or heart failure readmission in elderly patients admitted for cardiogenic pulmonary edema?
Hazard Ratio: 3.6233
p-value: p=0.0009
Predischarge BNP levels strongly predict 6-month mortality and heart failure readmission in elderly patients hospitalized for cardiogenic pulmonary edema.
May support predischarge BNP for risk stratification in elderly cardiogenic pulmonary edema; leaves open prospective validation before clinical adoption.
To examine the prognostic role of predischarge B-type natriuretic peptide (BNP) levels in elderly patients admitted to the hospital due to cardiogenic pulmonary edema, 203 patients consecutively admitted to the Heart Failure Unit of the Cardiology Department were retrospectively evaluated. The primary clinical end point selected was a combination of: 1) deaths; plus 2) readmissions to the hospital for heart failure in the 6 months after discharge. Thirty-one deaths (15.3%) and 44 readmissions for heart failure (21.7%) were recorded. Cox multivariate regression analysis confirmed that BNP cutoff values (identified on receiver-operated curve analysis) are the most accurate predictor of events. Hazard ratios (HRs) increased from the lowest, for BNP < or = 200 pg/mL (HR=1), through BNP 201-499 pg/mL (HR=2.3200; p=0.0174), to the highest, for BNP > or = 500 pg/mL (HR=3.6233; p=0.0009). This study demonstrates that BNP is useful in predischarge risk stratification of elderly patients with cardiogenic pulmonary edema.
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Valle et al. (2006) conducted a cohort in Cardiogenic pulmonary edema (n=203). Predischarge B-type natriuretic peptide (BNP) levels vs. BNP ≤ 200 pg/mL was evaluated on Combination of deaths and readmissions to the hospital for heart failure in the 6 months after discharge (HR 3.6233, p=0.0009). Predischarge BNP levels ≥500 pg/mL significantly predicted 6-month death or heart failure readmission in elderly patients with cardiogenic pulmonary edema compared to ≤200 pg/mL (HR 3.6233; p=0.0009).
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