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Review
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Korean J Med. 2006;71(1):289-289.
- Mid-term OPD plasma NT-proBNP level after hospital discharge predicts cardiac event in patient with dilated cardiomyopathy diagnosed on admission
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- Mid-term OPD plasma NT-proBNP level after hospital discharge predicts cardiac event in patient with dilated cardiomyopathy diagnosed on admission
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1Department of Internal Medicine, Hanyang University College of Medicine, Seoul; 2Department of Life Science, Postech Biotech Center, Pohang University of Science and Technology, Pohang, Korea
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- Abstract
- Background : Heart failure is a progressive chronic disease that causes high morbidity and mortality. Depending on their age
and HF stage, 10 -58 % of patients are readmitted within 3-6 months after discharge. Pre-discharge BNP level has been known
as a strong independent predictor of early readmission or death due to HF. Objectives : The aims of this study were to determine
the value of NT-proBNP levels to predict re-hospitalization or cardiac death, and compared them to the predischarge
echocardiographic or laboratory parameter which has been known to be related with cardiac event in patient with DCM
diagnosed on admission. Methods : We evaluated the outcomes of 42 patients with DCM diagnosed on admission at Samsung
Medical Center between January 2003 and February 2006. The diagnosis of DCM was based on echocardiography, coronary
angiography and/or cardiac biopsy. The patients consisted of were idiopathic DCM (37 patients), alcoholic DCM (3 patients), and
adriamycin-induced DCM (2 patients). Laboratory measurements including hemoglobin, sodium, creatinine etc. and
echocardiography were performed at predischarge period. We measured levels of NT-proBNP serially at the time of admission,
before discharge, and 3- 6months after discharge and 1 year after discharge. Results : During a mean follow-up period of 497
days we observed a 28.6% cardiac event rate. Among serial NT-proBNP measurement, mid-term (mean 87th day after
discharge) OPD NT-proBNP level shows a strong predictor of cardiac event with area under the ROC curve of 0.914. The
optimal mid-term OPD NT-proBNP cut-off level predicting readmission or cardiac death during follow-up period was 1100
pg/ml, which had a sensitivity of 83.3% and a specificity of 77.8% and patients above this threshold showed 17.7 hazard ratio
of cardiac event compared with patients below this threshold. Conclusions : Mid-term OPD plasma NT-proBNP level after
hospital discharge predicts cardiac event in patient with dilated cardiomyopathy diagnosed on admission. The optimal cut-off
NT-proBNP level was 1100 pg/ml and measurement of mid-term OPD NT-proBNP may be useful in therapeutic monitoring or
prognostic guideline for patients with DCM in outpatients clinics.
Keywords :
