Korean Circ J.  2007 May;37(5):202-207. 10.4070/kcj.2007.37.5.202.

N-terminal Pro B-type Natriuretic Peptide Predicts Cardiac Events in Discharged Patients with Idiopathic Dilated Cardiomyopathy

• Kim HJ
• Jeon ES
• Choi JO
• Lee WS
• Shin DH
• Cho SW
• Hahn JY
• Lee SC
• Park SW
• Lee SH

• KMID: 2227065
• DOI: http://doi.org/10.4070/kcj.2007.37.5.202

Abstract

BACKGROUND AND OBJECTIVES: Heart failure is a progressive chronic disease with high morbidity and mortality. The aim of this study was to determine whether the N-terminal pro B-type natriuretic peptide (NT-proBNP) levels in the blood can predict readmission due to heart failure or cardiac death (cardiac event) following hospital discharge, and if these are a better predictive marker than a pre-discharge echocardiogram or other laboratory parameters in discharged patients with idiopathic dilated cardiomyopathy (DCM).
SUBJECTS AND METHODS
The outcomes of 36 patients with idiopathic DCM, diagnosed on hospital admission, were retrospectively evaluated.
RESULTS
During a mean follow-up period of 520 days, a 22.2% rate of cardiac events was observed. Evaluation of the NT-proBNPs showed the mid-term (mean 84th day after discharge) outpatient (OPD) NT-proBNP levels to be a strong predictor of cardiac events, with an area under the curve analysis of 0.90. The optimal mid-term OPD NT-proBNP cut-off level for predicting cardiac events was 1500 pg/mL, with a sensitivity and specificity of 80 and 92%, respectively; patients with levels above this threshold had a 22.9 hazard ratio for cardiac events compared to those with levels below this threshold.
CONCLUSION
The mid-term OPD plasma NT-proBNP levels were able to predict cardiac events in discharged patients with idiopathic DCM, regardless of the admission or pre-discharge NT-proBNP levels and other laboratory parameters. The measurement of OPD NT-proBNP at the mid term follow-up may be useful in outpatient therapeutic monitoring or for the development of prognostic guidelines in patients with idiopathic DCM.

Keyword

Cardiomyopathy dilated; N-terminal pro-brain natriuretic peptide; Predictive value of tests; Cardiac event

MeSH Terms

Cardiomyopathy, Dilated*
Chronic Disease
Death
Follow-Up Studies
Heart Failure
Humans
Mortality
Natriuretic Peptide, Brain*
Outpatients
Plasma
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Natriuretic Peptide, Brain

Figure

• 

  Fig. 1 Receiver operating characteristic curve for the mid-term OPD N-terminal pro-B-type natriuretic peptide cut-off values and their association with cardiac events during follow-up. OPD: outpatient department.

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  Fig. 2 Kaplan-Meier curves according to the predefined mid-term OPD N-terminal pro-B-type natriuretic peptide cut-off (1,500 pg/mL) level. OPD: outpatient department.

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