4.6 Article

N-terminal pro-B-type natriuretic peptide and outcomes in type B aortic dissection in China: a retrospective multicentre study

期刊

BMJ OPEN
卷 9, 期 9, 页码 -

出版社

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2019-029885

关键词

Brain natriuretic peptide; aortic dissection; prognosis

资金

  1. projects of provincial health and family planning commission of Guangxi [Z2016271/Z20170024/Z20170021]

向作者/读者索取更多资源

Objectives N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is an unfavourable factor responsible for poor outcomes in the cardiovascular diseases. Nevertheless, the prognostic role of NT-pro-BNP in type B aortic dissection (TBAD) remains unclear. The aim of the current study was to investigate the relationship between NT-pro-BNP levels and in-hospital and long-term adverse prognosis in patients with TBAD. Design A retrospective multicentre study. Setting Liutie Central Hospital, Nanfang Hospital and Huiyang Hospital in China. Participants A total of 657 consecutive patients with TBAD were enrolled in the study. NT-pro-BNP was measured at admission and included patients were divided into three groups according to the tertiles of NT-pro-BNP (pg/mL): <95 (n=220), 95-312 (n=218) and >312 (n=219). Primary and secondary outcome measures Long-term mortality and in-hospital major adverse clinical events. Results Overall, in-hospital death occurred in 27 patients (4.1%), which was significantly higher in upper tertiles of NT-pro-BNP (0.5% vs 4.1% vs 7.8%, p<0.001). The incident of in-hospital major adverse clinical events increased along with higher NT-pro-BNP (1.4% vs 11.5% vs 15.5%, p<0.001). NT-pro-BNP >210pg/mL had 81.5% sensitivity and 58.6% specificity for predicting in-hospital death (area under the curve= 0.774, 95%CI 0.692 to 0.855; p<0.001). After a median of 3.1 years of follow-up, 97 (14.8%) patients died. The Kaplan-Meier analysis indicated that the long-term cumulative mortality was higher in patients with NT-pro-BNP >210pg/mL compared with patients with NT-pro-BNP <= 210pg/mL (log-rank=26.92, p<0.001). In multivariable Cox survival modelling, NT-pro-BNP >210pg/mL was independently associated with long-term death (adjusted HR 2.47, 95%CI 1.45 to 4.22, p=0.001). Conclusions NT-pro-BNP resulted as an independent predictor of adverse prognosis in patients with TBAD, thus could be used as a potential risk-stratification tool.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据