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首页> 外文期刊>The American Journal of Cardiology >Usefulness of N-Terminal Pro-Brain Natriuretic Peptide to Predict Mortality in Adults With Congenital Heart Disease
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Usefulness of N-Terminal Pro-Brain Natriuretic Peptide to Predict Mortality in Adults With Congenital Heart Disease

机译：N末端脑前利尿钠肽可预测先天性心脏病成人的死亡率

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摘要

Natriuretic peptides are often elevated in congenital heart disease (CHD); however, the clinical impact on mortality is unclear. The aim of our study was to evaluate the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the prediction of all-cause mortality in adults with different CHD. In this prospective longitudinal mortality study, we evaluated NT-proBNP in 1,242 blood samples from 646 outpatient adults with stable CHD (mean age 35 12 years; 345 women). Patients were followed up for 6 3 (1 to 10) years. The mortality rate was 5% (35 patients, mean age 40 14 years, 17 women). Median NT-proBNP (pg/ml) was 220 in the whole cohort, 203 in survivors, and 1,548 in deceased patients. The best discrimination value for mortality prediction was 630 pg/ml with 74% sensitivity and 84% specificity. During the follow-up, the survival rate was 65% for those with median NT-proBNP >= 630 pg/ml and 94% for NT-proBNP <630 pg/ml; p < 0.0001. There was only 1% mortality among 388 patients with at least 1 NT-proBNP value <= 220 pg/ml compared with 41% mortality among 54 patients with at least 1 NT-proBNP value >1,548 pg/ml. Even the first (baseline) measurements of NT-proBNP were strongly associated with a high risk of death (log(10) NT-proBNP had hazard ratio 7, p < 0.0001). In conclusion, NT-proBNP assessment is a useful and simple tool for the prediction of mortality in long-term follow-up of adults with CHD. (C) 2015 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
机译：利钠肽通常在先天性心脏病（CHD）中升高;但是，对死亡率的临床影响尚不清楚。我们研究的目的是评估N末端前脑利钠肽（NT-proBNP）在预测患有不同冠心病的成人全因死亡率中的预后价值。在这项前瞻性纵向死亡率研究中，我们评估了646名稳定冠心病门诊成人（平均年龄35 12岁; 345名女性）的1,242份血液样本中的NT-proBNP。对患者进行了6 3（1至10）年的随访。死亡率为5％（35例患者，平均年龄40 14岁，17名妇女）。在整个队列中，NT-proBNP（pg / ml）的中位数为220，幸存者中为203，死者中为1,548。死亡率预测的最佳判别值为630 pg / ml，灵敏度为74％，特异性为84％。在随访期间，中位NT-proBNP> = 630 pg / ml的患者的生存率为65％，NT-proBNP <630 pg / ml的患者的生存率为94％; p ＜0.0001。在至少1个NT-proBNP值<= 220 pg / ml的388例患者中，只有1％的死亡率，而在至少1个NT-proBNP值> 1,548 pg / ml的54例患者中，死亡率为41％。甚至NT-proBNP的首次（基线）测量值都与高死亡风险密切相关（log（10）NT-proBNP的危险比为7，p <0.0001）。总之，NT-proBNP评估是预测成人冠心病长期随访死亡率的有用且简单的工具。 （C）2015作者。由Elsevier Inc.发行。这是CC BY-NC-ND许可下的开放获取文章（http://creativecommons.org/licenses/by-nc-nd/4.0/）。

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