What does this research mean for the field?

In patients with advanced chronic heart failure referred for cardiac transplantation, elevated NT-proBNP is a superior predictor of all-cause mortality compared to endothelin-1, adrenomedullin, and TNF-alpha. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

August 5, 2004European Journal of Heart Failure

N-Terminal Brain Natriuretic Peptide is a More Powerful Predictor of Mortality than Endothelin-1, Adrenomedullin and Tumour Necrosis Factor-α in Patients Referred for Consideration of Cardiac Transplantation

Q: What are the key findings of this study?

An NT-proBNP concentration above the median value was the only significant predictor of all-cause mortality (P<0.0001), outperforming endothelin-1, adrenomedullin, and TNF-alpha.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Advanced heart failure (n=150). Intervention: N-terminal brain natriuretic peptide (NT-proBNP) vs. Endothelin-1, adrenomedullin, and tumour necrosis factor-alpha. Primary outcome: All-cause mortality (p=<0.0001).

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Key result

Above-median NT-proBNP predicts all-cause mortality, outperforming endothelin-1, adrenomedullin, and TNF-alpha.

P<0.0001
n=150

Why the study?

The comparative prognostic power of endothelin-1, adrenomedullin and tumour necrosis factor-alpha versus NT-proBNP in patients with advanced chronic heart failure referred for cardiac transplantation was unknown.

Does NT-proBNP predict mortality better than Et-1, Adm, and TNF-alpha in patients with advanced CHF referred for cardiac transplantation?

Study Design

Type

Cohort (n=150)

Structured PICO

Does NT-proBNP predict mortality better than Et-1, Adm, and TNF-alpha in patients with advanced CHF referred for cardiac transplantation?

Population

150 consecutive patients with advanced heart failure referred for consideration of cardiac transplantation, followed for a median of 666 days.

Exposure

Measurement of N-terminal brain natriuretic peptide (NT-proBNP), endothelin-1 (Et-1), adrenomedullin (Adm) and tumour necrosis factor-alpha (TNF-alpha)

Outcome

All-cause mortalityhard clinical

Main Result

p-value: p=<0.0001

A single measurement of NT-proBNP is a superior prognostic marker compared to Et-1, Adm, and TNF-alpha for identifying patients with advanced CHF at the highest risk of death.

Discussion

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Implication

NT-proBNP above median independently predicted mortality in advanced HF transplant candidates; supports superiority over Et-1, Adm and TNF-α but leaves practice change open pending prospective validation.

Cite This Study

Gardner et al. (2004) conducted a cohort in Advanced heart failure (n=150). N-terminal brain natriuretic peptide (NT-proBNP) vs. Endothelin-1, adrenomedullin, and tumour necrosis factor-alpha was evaluated on All-cause mortality (p=<0.0001). An NT-proBNP concentration above the median value was the only significant predictor of all-cause mortality (P<0.0001), outperforming endothelin-1, adrenomedullin, and TNF-alpha.

synapsesocial.com/papers/6aa8fe14b7876cb3302c88ab https://doi.org/10.1016/j.ejheart.2004.06.002

Topics

Heart failure HFrEF treatment

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N-Terminal Brain Natriuretic Peptide is a More Powerful Predictor of Mortality than Endothelin-1, Adrenomedullin and Tumour Necrosis Factor-α in Patients Referred for Consideration of Cardiac Transplantation

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

N-Terminal Brain Natriuretic Peptide is a More Powerful Predictor of Mortality than Endothelin-1, Adrenomedullin and Tumour Necrosis Factor-α in Patients Referred for Consideration of Cardiac Transplantation

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider