Prognostic value of short-term follow-up B-type natriuretic peptide levels after hospital discharge in patients with acute myocardial infarction

Jun Won Lee, Eunhee Choi, Sayma Sabrina Khanam, Jung Woo Son, Young Jin Youn, Min Soo Ahn, Sung Gyun Ahn, Jang Young Kim, Seung Hwan Lee, Junghan Yoon, Byung Su Yoo

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Abstract

Background: Elevated B-type natriuretic peptide (BNP) levels in patients hospitalized for acute myocardial infarction (AMI) are associated with heart failure and mortality. However, the role of BNP after hospital discharge is not clear. Therefore, we assessed the relationship between short-term follow-up BNP levels and clinical outcomes including all-cause mortality and major adverse cardiovascular events (MACE) in patients with AMI after hospital discharge. Methods: From a prospective single-center percutaneous coronary intervention (PCI) registry, a total of 442 out of 2157 patients with AMI who had measurements for both initial and follow-up BNP levels within 2 months after discharge were retrospectively enrolled. Patients were divided into 4 groups (low-low, high-low, low-high, and high-high) according to their follow-up log-transformed BNP median values. Results: The median follow-up period was 441 days (interquartile range [IQR], 362–861 days). Logistic regression analysis demonstrated that short-term follow-up BNP level was a significant predictor for all-cause mortality (odds ratio [OR], 2.265; 95% confidence interval [CI], 1.455–3.527) and MACE (OR, 1.43; 95% CI, 1.101–1.858) after adjustments for covariates. The initial BNP level did not predict both all-cause mortality and MACE. The group with high initial and high follow-up BNP levels was significantly associated with all-cause mortality (OR, 3.465; 95% CI, 1.122–10.700). Conclusions: Short-term follow-up BNP level after hospital discharge was a powerful prognostic marker for all-cause mortality and MACE in patients with AMI. The combination of short-term follow-up BNP level with initial BNP level was a better predictor of all-cause mortality.

Original languageEnglish
Pages (from-to)19-23
Number of pages5
JournalInternational Journal of Cardiology
Volume289
DOIs
Publication statusPublished - 2019 Aug 15

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Patient Discharge
Brain Natriuretic Peptide
Myocardial Infarction
Mortality
Odds Ratio
Confidence Intervals
Percutaneous Coronary Intervention
Registries
Heart Failure
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{5da52810ceaa47a6a72f3b9130eb3710,
title = "Prognostic value of short-term follow-up B-type natriuretic peptide levels after hospital discharge in patients with acute myocardial infarction",
abstract = "Background: Elevated B-type natriuretic peptide (BNP) levels in patients hospitalized for acute myocardial infarction (AMI) are associated with heart failure and mortality. However, the role of BNP after hospital discharge is not clear. Therefore, we assessed the relationship between short-term follow-up BNP levels and clinical outcomes including all-cause mortality and major adverse cardiovascular events (MACE) in patients with AMI after hospital discharge. Methods: From a prospective single-center percutaneous coronary intervention (PCI) registry, a total of 442 out of 2157 patients with AMI who had measurements for both initial and follow-up BNP levels within 2 months after discharge were retrospectively enrolled. Patients were divided into 4 groups (low-low, high-low, low-high, and high-high) according to their follow-up log-transformed BNP median values. Results: The median follow-up period was 441 days (interquartile range [IQR], 362–861 days). Logistic regression analysis demonstrated that short-term follow-up BNP level was a significant predictor for all-cause mortality (odds ratio [OR], 2.265; 95{\%} confidence interval [CI], 1.455–3.527) and MACE (OR, 1.43; 95{\%} CI, 1.101–1.858) after adjustments for covariates. The initial BNP level did not predict both all-cause mortality and MACE. The group with high initial and high follow-up BNP levels was significantly associated with all-cause mortality (OR, 3.465; 95{\%} CI, 1.122–10.700). Conclusions: Short-term follow-up BNP level after hospital discharge was a powerful prognostic marker for all-cause mortality and MACE in patients with AMI. The combination of short-term follow-up BNP level with initial BNP level was a better predictor of all-cause mortality.",
author = "Lee, {Jun Won} and Eunhee Choi and Khanam, {Sayma Sabrina} and Son, {Jung Woo} and Youn, {Young Jin} and Ahn, {Min Soo} and Ahn, {Sung Gyun} and Kim, {Jang Young} and Lee, {Seung Hwan} and Junghan Yoon and Yoo, {Byung Su}",
year = "2019",
month = "8",
day = "15",
doi = "10.1016/j.ijcard.2019.01.026",
language = "English",
volume = "289",
pages = "19--23",
journal = "International Journal of Cardiology",
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TY - JOUR

T1 - Prognostic value of short-term follow-up B-type natriuretic peptide levels after hospital discharge in patients with acute myocardial infarction

AU - Lee, Jun Won

AU - Choi, Eunhee

AU - Khanam, Sayma Sabrina

AU - Son, Jung Woo

AU - Youn, Young Jin

AU - Ahn, Min Soo

AU - Ahn, Sung Gyun

AU - Kim, Jang Young

AU - Lee, Seung Hwan

AU - Yoon, Junghan

AU - Yoo, Byung Su

PY - 2019/8/15

Y1 - 2019/8/15

N2 - Background: Elevated B-type natriuretic peptide (BNP) levels in patients hospitalized for acute myocardial infarction (AMI) are associated with heart failure and mortality. However, the role of BNP after hospital discharge is not clear. Therefore, we assessed the relationship between short-term follow-up BNP levels and clinical outcomes including all-cause mortality and major adverse cardiovascular events (MACE) in patients with AMI after hospital discharge. Methods: From a prospective single-center percutaneous coronary intervention (PCI) registry, a total of 442 out of 2157 patients with AMI who had measurements for both initial and follow-up BNP levels within 2 months after discharge were retrospectively enrolled. Patients were divided into 4 groups (low-low, high-low, low-high, and high-high) according to their follow-up log-transformed BNP median values. Results: The median follow-up period was 441 days (interquartile range [IQR], 362–861 days). Logistic regression analysis demonstrated that short-term follow-up BNP level was a significant predictor for all-cause mortality (odds ratio [OR], 2.265; 95% confidence interval [CI], 1.455–3.527) and MACE (OR, 1.43; 95% CI, 1.101–1.858) after adjustments for covariates. The initial BNP level did not predict both all-cause mortality and MACE. The group with high initial and high follow-up BNP levels was significantly associated with all-cause mortality (OR, 3.465; 95% CI, 1.122–10.700). Conclusions: Short-term follow-up BNP level after hospital discharge was a powerful prognostic marker for all-cause mortality and MACE in patients with AMI. The combination of short-term follow-up BNP level with initial BNP level was a better predictor of all-cause mortality.

AB - Background: Elevated B-type natriuretic peptide (BNP) levels in patients hospitalized for acute myocardial infarction (AMI) are associated with heart failure and mortality. However, the role of BNP after hospital discharge is not clear. Therefore, we assessed the relationship between short-term follow-up BNP levels and clinical outcomes including all-cause mortality and major adverse cardiovascular events (MACE) in patients with AMI after hospital discharge. Methods: From a prospective single-center percutaneous coronary intervention (PCI) registry, a total of 442 out of 2157 patients with AMI who had measurements for both initial and follow-up BNP levels within 2 months after discharge were retrospectively enrolled. Patients were divided into 4 groups (low-low, high-low, low-high, and high-high) according to their follow-up log-transformed BNP median values. Results: The median follow-up period was 441 days (interquartile range [IQR], 362–861 days). Logistic regression analysis demonstrated that short-term follow-up BNP level was a significant predictor for all-cause mortality (odds ratio [OR], 2.265; 95% confidence interval [CI], 1.455–3.527) and MACE (OR, 1.43; 95% CI, 1.101–1.858) after adjustments for covariates. The initial BNP level did not predict both all-cause mortality and MACE. The group with high initial and high follow-up BNP levels was significantly associated with all-cause mortality (OR, 3.465; 95% CI, 1.122–10.700). Conclusions: Short-term follow-up BNP level after hospital discharge was a powerful prognostic marker for all-cause mortality and MACE in patients with AMI. The combination of short-term follow-up BNP level with initial BNP level was a better predictor of all-cause mortality.

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U2 - 10.1016/j.ijcard.2019.01.026

DO - 10.1016/j.ijcard.2019.01.026

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AN - SCOPUS:85059749461

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JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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