Prognostic Significance of First Week NT-ProBNP Levels in Heart Failure

Introduction: Clinical history, signs and symptoms along with non-invasive imaging help in diagnosis and management of Heart Failure (HF). Limited data exists in evaluating the role of cardiac biomarkers in diagnostic and prognostic work up in cases with clinical evidence of HF in an Indian setup. A...

Full description

Bibliographic Details
Main Authors: SHOBHITENDU KABI, SIBA PRASAD DALAI, KAMAL KANT JENA, AKSHAYA KUMAR SAMAL, BAIKUNTHA NATH PANDA, SRIKANT KUMAR DHAR
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2018-09-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/12009/35533_CE[Ra]_F(Sh)_PF1(AGAK)_PFA(AK)_PB(AG_SS)_PN(SS).pdf
_version_ 1819289841825742848
author SHOBHITENDU KABI
SIBA PRASAD DALAI
KAMAL KANT JENA
AKSHAYA KUMAR SAMAL
BAIKUNTHA NATH PANDA
SRIKANT KUMAR DHAR
author_facet SHOBHITENDU KABI
SIBA PRASAD DALAI
KAMAL KANT JENA
AKSHAYA KUMAR SAMAL
BAIKUNTHA NATH PANDA
SRIKANT KUMAR DHAR
author_sort SHOBHITENDU KABI
collection DOAJ
description Introduction: Clinical history, signs and symptoms along with non-invasive imaging help in diagnosis and management of Heart Failure (HF). Limited data exists in evaluating the role of cardiac biomarkers in diagnostic and prognostic work up in cases with clinical evidence of HF in an Indian setup. Aim: The aim was to find out if first week N-Terminal -pro Brain Natriuretic Peptide (NT-proBNP) levels can be used as a prognostic indicator and to correlate with duration of hospital stay and mortality during the course of treatment and followup. Materials and Methods: A hospital based cross-sectional observational study was carried out for a period of two years and 160 patients with clinical evidence of HF according to Framingham’s criteria irrespective of aetiology and ejection fraction were included in the study. NT-proBNP were estimated at admission, at one-week interval and at discharge. NTproBNP levels were correlated with duration of hospital stay and mortality during the course of treatment and follow-up. Results: Patients with Rheumatic Heart Disease (RHD) had the highest mean NT-proBNP levels even with higher ejection fractions. Mean NT-proBNP levels in patients with Cor-pulmonale were significantly lower (3634.8 pg/dL) than patients of HF with non-pulmonary cause (8418 pg/dL). Patients with NT-proBNP levels more than 15,000 pg/dL invariably stayed for more than two weeks. The decline of NT-proBNP levels more than 90% of the initial values in one week follow up were prognostic marker for recovery (p<0.01). Patients who had admission NT-proBNP levels of more than 10,000 pg/dL, and those cases with fall of NT-proBNP levels less than 50% after one week of therapy had increased duration of hospital stay and or higher risk of mortality. Conclusion: First week NT-proBNP can be used routinely in monitoring the response to therapy, prognosticate the duration of hospital stay, outcome in HF.
first_indexed 2024-12-24T03:13:16Z
format Article
id doaj.art-b69134354971450ea5acb2e4ebd65aac
institution Directory Open Access Journal
issn 2249-782X
0973-709X
language English
last_indexed 2024-12-24T03:13:16Z
publishDate 2018-09-01
publisher JCDR Research and Publications Private Limited
record_format Article
series Journal of Clinical and Diagnostic Research
spelling doaj.art-b69134354971450ea5acb2e4ebd65aac2022-12-21T17:17:44ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-09-01129OC14OC1710.7860/JCDR/2018/35533.12009Prognostic Significance of First Week NT-ProBNP Levels in Heart FailureSHOBHITENDU KABI0SIBA PRASAD DALAI1KAMAL KANT JENA2AKSHAYA KUMAR SAMAL3BAIKUNTHA NATH PANDA4SRIKANT KUMAR DHAR5Associate Professor, Department of Medicine, Ims and SUM Hospital, Bhubaneswar, Odisha, India.Senior Resident, Department of Medicine, Ims and SUM Hospital, Bhubaneswar, Odisha, India.Junior Resident, Department of Medicine, Ims and SUM Hospital, Bhubaneswar, Odisha, India.Professor, Department of Cardiology, Ims and SUM Hospital, Bhubaneswar, Odisha, India.Professor, Department of Medicine, Ims and SUM Hospital, Bhubaneswar, Odisha, India.Associate Professor, Department of Medicine, Ims and SUM Hospital, Bhubaneswar, Odisha, India.Introduction: Clinical history, signs and symptoms along with non-invasive imaging help in diagnosis and management of Heart Failure (HF). Limited data exists in evaluating the role of cardiac biomarkers in diagnostic and prognostic work up in cases with clinical evidence of HF in an Indian setup. Aim: The aim was to find out if first week N-Terminal -pro Brain Natriuretic Peptide (NT-proBNP) levels can be used as a prognostic indicator and to correlate with duration of hospital stay and mortality during the course of treatment and followup. Materials and Methods: A hospital based cross-sectional observational study was carried out for a period of two years and 160 patients with clinical evidence of HF according to Framingham’s criteria irrespective of aetiology and ejection fraction were included in the study. NT-proBNP were estimated at admission, at one-week interval and at discharge. NTproBNP levels were correlated with duration of hospital stay and mortality during the course of treatment and follow-up. Results: Patients with Rheumatic Heart Disease (RHD) had the highest mean NT-proBNP levels even with higher ejection fractions. Mean NT-proBNP levels in patients with Cor-pulmonale were significantly lower (3634.8 pg/dL) than patients of HF with non-pulmonary cause (8418 pg/dL). Patients with NT-proBNP levels more than 15,000 pg/dL invariably stayed for more than two weeks. The decline of NT-proBNP levels more than 90% of the initial values in one week follow up were prognostic marker for recovery (p<0.01). Patients who had admission NT-proBNP levels of more than 10,000 pg/dL, and those cases with fall of NT-proBNP levels less than 50% after one week of therapy had increased duration of hospital stay and or higher risk of mortality. Conclusion: First week NT-proBNP can be used routinely in monitoring the response to therapy, prognosticate the duration of hospital stay, outcome in HF.https://jcdr.net/articles/PDF/12009/35533_CE[Ra]_F(Sh)_PF1(AGAK)_PFA(AK)_PB(AG_SS)_PN(SS).pdfbiomarkershospital staymortalitynon-invasive markers
spellingShingle SHOBHITENDU KABI
SIBA PRASAD DALAI
KAMAL KANT JENA
AKSHAYA KUMAR SAMAL
BAIKUNTHA NATH PANDA
SRIKANT KUMAR DHAR
Prognostic Significance of First Week NT-ProBNP Levels in Heart Failure
Journal of Clinical and Diagnostic Research
biomarkers
hospital stay
mortality
non-invasive markers
title Prognostic Significance of First Week NT-ProBNP Levels in Heart Failure
title_full Prognostic Significance of First Week NT-ProBNP Levels in Heart Failure
title_fullStr Prognostic Significance of First Week NT-ProBNP Levels in Heart Failure
title_full_unstemmed Prognostic Significance of First Week NT-ProBNP Levels in Heart Failure
title_short Prognostic Significance of First Week NT-ProBNP Levels in Heart Failure
title_sort prognostic significance of first week nt probnp levels in heart failure
topic biomarkers
hospital stay
mortality
non-invasive markers
url https://jcdr.net/articles/PDF/12009/35533_CE[Ra]_F(Sh)_PF1(AGAK)_PFA(AK)_PB(AG_SS)_PN(SS).pdf
work_keys_str_mv AT shobhitendukabi prognosticsignificanceoffirstweekntprobnplevelsinheartfailure
AT sibaprasaddalai prognosticsignificanceoffirstweekntprobnplevelsinheartfailure
AT kamalkantjena prognosticsignificanceoffirstweekntprobnplevelsinheartfailure
AT akshayakumarsamal prognosticsignificanceoffirstweekntprobnplevelsinheartfailure
AT baikunthanathpanda prognosticsignificanceoffirstweekntprobnplevelsinheartfailure
AT srikantkumardhar prognosticsignificanceoffirstweekntprobnplevelsinheartfailure