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Article ; Online: Worsening renal function in patients hospitalized with acute heart failure: risk factors and prognostic significances.

Verdiani, Valerio / Lastrucci, Vieri / Nozzoli, Carlo

2010 Volume 2011, Page(s) 785974

Abstract: Objectives. To determine the prevalence, the clinical predictors, and the prognostic significances of Worsening Renal Function (WRF) in hospitalized patients with Acute Heart Failure (AHF). Methods. 394 consecutively hospitalized patients with AHF were ... ...

Abstract	Objectives. To determine the prevalence, the clinical predictors, and the prognostic significances of Worsening Renal Function (WRF) in hospitalized patients with Acute Heart Failure (AHF). Methods. 394 consecutively hospitalized patients with AHF were evaluated. WRF was defined as an increase in serum creatinine of ≥0.3 mg/dL from baseline to discharge. Results. Nearly 11% of patients developed WRF. The independent predictors of WRF analyzed with a multivariable logistic regression were history of chronic kidney disease (P = .047), age >75 years (P = .049), and admission heart rates ≥100 bpm (P = .004). Mortality or rehospitalization rates at 1 month, 6 months, and 1year were not significantly different between patients with WRF and those without WRF. Conclusion. Different clinical predictors at hospital admission can be used to identify patients at increased risk for developing WRF. Patients with WRF compared with those without WRF experienced no significant differences in hospital length of stay, mortality, or rehospitalization rates.
Language	English
Publishing date	2010-10-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573904-9
ISSN	2090-2158 ; 2090-214X
ISSN (online)	2090-2158
ISSN	2090-214X
DOI	10.4061/2011/785974
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Article: Spontaneous dissection of the celiac artery in the young: a case report and systematic review of the literature.

Tana, Marco / Tana, Claudio / Schiavone, Cosima / Verdiani, Valerio / Palermo, Carlo / Alessandri, Massimo / Giamberardino, Maria Adele / Montagnani, Andrea

Hospital practice (1995)

2017 Volume 45, Issue 5, Page(s) 258–264

Abstract: Introduction: The spontaneous isolated celiac artery dissection (siCAD) represents a challenging cause of abdominal pain and complete information regarding incidence, etiology and risk factors in the young is still lacking. In this study, we report a ... ...

Abstract	Introduction: The spontaneous isolated celiac artery dissection (siCAD) represents a challenging cause of abdominal pain and complete information regarding incidence, etiology and risk factors in the young is still lacking. In this study, we report a case of siCAD occurred in a young woman and we systematically searched for information on siCADs in literature databases. Methods: PubMed/Embase and Cochrane were searched for, using the following terms: Isolated celiac trunk dissection, isolated celiac artery dissection, celiac artery dissection, celiac trunk dissection, spontaneous isolated visceral artery dissection, spontaneous isolated dissection of visceral arteries, isolated celiac artery dissection in the young, isolated celiac trunk dissection in the young. Patients were included if they were younger than 50 years, if they had a spontaneous etiology and a selective involvement of the celiac artery (with or without involvement of its branches). Results: 180 studies were found, and 18 remained after screening. Twenty-one patients (male = 19, female = 2) with siCADs were included. Mean age was 44.71 ± 3.61 years. Hypertension was the most prevalent comorbidity. All patients presented with abdominal pain, more often located in the epigastrium (n = 11). Almost all patients underwent CT to confirm the diagnosis. A conservative treatment was adopted in 13 patients while an invasive approach was adopted in 8 patients (endovascular approach in 7). Discussion: siCADs represent a rare but important cause of vascular dissection in the young. Uncomplicated cases can be safely treated with conservative strategies. The surgical or endovascular repair is indicated when dissections complicate or symptoms persist despite an adequate conservative treatment.
MeSH term(s)	Adult ; Female ; Humans ; Abdominal Pain/etiology ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/pathology ; Celiac Artery/diagnostic imaging ; Celiac Artery/pathology ; Tomography, X-Ray Computed
Language	English
Publishing date	2017-09-15
Publishing country	England
Document type	Case Reports ; Journal Article ; Systematic Review
ZDB-ID	2570453-9
ISSN	2377-1003 ; 2154-8331 ; 8750-2836
ISSN (online)	2377-1003
ISSN	2154-8331 ; 8750-2836
DOI	10.1080/21548331.2017.1378059
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Article: Scompenso cardiaco: prevenire le riospedalizzazioni applicando programmi di gestione.

Verdiani, Valerio / Nozzoli, Carlo

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

2004 Volume 62, Issue 2, Page(s) 86–96

Abstract: Chronic heart failure is a growing public health problem for prevalence, morbidity and costs. The major proportion of costs is attributable to rehospitalizations and many of these readmissions may be preventable. Since 1990, some investigators have ... ...

Title translation	Heart failure: preventing rehospitalizations by disease management programs.
Abstract	Chronic heart failure is a growing public health problem for prevalence, morbidity and costs. The major proportion of costs is attributable to rehospitalizations and many of these readmissions may be preventable. Since 1990, some investigators have tested a variety of disease management programs designed to improve quality of life, functional status and decrease rehospitalizations rates. We identified these studies by a computerized search of the MEDLINE database. The programs described reflected a wide variety of methods and we categorized these programs recognizing the prevalent disease management approach. We reported the results of these trials about rehospitalizations and analysed a number of limitations that must be considered when determining their adoption into clinical practice.
MeSH term(s)	Disease Management ; Family Practice ; Heart Failure/prevention & control ; Home Care Services ; Humans ; Patient Care Planning ; Patient Readmission ; Telemedicine
Language	Italian
Publishing date	2004-06
Publishing country	Italy
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	1160940-0
ISSN	1122-0643 ; 1120-0391
ISSN	1122-0643 ; 1120-0391
DOI	10.4081/monaldi.2004.674
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Article ; Online: Prognosis and NT-proBNP in heart failure patients with preserved versus reduced ejection fraction.

Salah, Khibar / Stienen, Susan / Pinto, Yigal M / Eurlings, Luc W / Metra, Marco / Bayes-Genis, Antoni / Verdiani, Valerio / Tijssen, Jan G P / Kok, Wouter E

Heart (British Cardiac Society)

2019 Volume 105, Issue 15, Page(s) 1182–1189

Abstract: Background: We assessed the prognostic significance of absolute and percentage change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients hospitalised for acute decompensated heart failure with preservedejection fraction (HFpEF) ... ...

Abstract	Background: We assessed the prognostic significance of absolute and percentage change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients hospitalised for acute decompensated heart failure with preservedejection fraction (HFpEF) versus heart failure with reduced ejection fraction (HFrEF). Methods: Patients with left ventricular ejection fraction ≥50% were categorised as HFpEF (n=283), while those with <40% as were categorised as HFrEF (n=776). Prognostic values of absolute and percentage change in NT-proBNP levels for 6 months all-cause mortality after discharge were assessed separately in patients with HFpEF and HFrEF by multivariable adjusted Cox regression analysis. Comorbidities were compared between heart failure groups. Results: Discharge NT-proBNP levels predicted outcome similarly in HFpEF and HFrEF: for any 2.7-factor increase in NT-proBNP levels, the HR for mortality was 2.14 for HFpEF (95% CI 1.48 to 3.09) and 1.96 for HFrEF (95% CI 1.60 to 2.40). Mortality prediction was equally possible for NT-proBNP reduction of ≤30% (HR 4.60, 95% CI 1.47 to 14.40 and HR 3.36, 95% CI 1.93 to 5.85 for HFpEF and HFrEF, respectively) and for >30%-60% (HR 3.28, 95% CI 1.07 to 10.12 and HR 1.79, 95% CI 0.99 to 3.26, respectively), compared with mortality in the reference groups of >60% reductions in NT-proBNP levels. Prognostically relevant comorbidities were more often present in patients with HFpEF than patients with HFrEF in low (≤3000 pg/mL) but not in high (>3000 pg/mL) NT-proBNP discharge categories. Conclusions: Our study highlights-after demonstrating that NT-proBNP levels confer the same relative risk information in HFpEF as in HFrEF-the possibility that comorbidities contribute relatively more to prognosis in patients with HFpEF with lower NT-proBNP levels than in patients with HFrEF.
MeSH term(s)	Aged ; Aged, 80 and over ; Biomarkers/blood ; Case-Control Studies ; Female ; Heart Failure/blood ; Heart Failure/mortality ; Heart Failure/physiopathology ; Hospitalization ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Prognosis ; Stroke Volume/physiology ; Survival Rate
Chemical Substances	Biomarkers ; Peptide Fragments ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2019-04-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1303417-0
ISSN	1468-201X ; 1355-6037
ISSN (online)	1468-201X
ISSN	1355-6037
DOI	10.1136/heartjnl-2018-314173
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Article ; Online: The predictive role of the Bova risk score in acute normotensive pulmonary embolism: A retrospective analysis on a real life cohort.

Masotti, Luca / Verdiani, Valerio / Cei, Marco / Cioppi, Adriano / Di Natale, Massimo / Panigada, Grazia / Landini, Giancarlo

Thrombosis research

2015 Volume 137, Page(s) 221–223

MeSH term(s)	Aged ; Blood Pressure Determination/statistics & numerical data ; Cohort Studies ; Electrocardiography/statistics & numerical data ; Female ; Humans ; Italy/epidemiology ; Male ; Proportional Hazards Models ; Pulmonary Embolism/blood ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/mortality ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment/methods ; Sensitivity and Specificity ; Survival Analysis ; Troponin/blood ; Ventricular Dysfunction, Right/blood ; Ventricular Dysfunction, Right/diagnosis ; Ventricular Dysfunction, Right/mortality
Chemical Substances	Troponin
Language	English
Publishing date	2015-11-21
Publishing country	United States
Document type	Letter
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2015.11.021
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Article ; Online: Targeting N-Terminal Pro-Brain Natriuretic Peptide in Older Versus Younger Acute Decompensated Heart Failure Patients.

Stienen, Susan / Salah, Khibar / Eurlings, Luc W / Bettencourt, Paulo / Pimenta, Joana M / Metra, Marco / Bayes-Genis, Antoni / Verdiani, Valerio / Bettari, Luca / Lazzarini, Valentina / Tijssen, Jan P / Pinto, Yigal M / Kok, Wouter E

JACC. Heart failure

2016 Volume 4, Issue 9, Page(s) 736–745

Abstract: Objectives: The aim of this study was to analyze the prognostic value and attainability of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in young and elderly acute decompensated heart failure (ADHF) patients.: Background: Less-effective ...

Abstract	Objectives: The aim of this study was to analyze the prognostic value and attainability of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in young and elderly acute decompensated heart failure (ADHF) patients. Background: Less-effective NT-proBNP-guided therapy in chronic heart failure (HF) has been reported in elderly patients. Whether this can be attributed to differences in prognostic value of NT-proBNP or to differences in attaining a prognostic value is unclear. The authors studied this question in ADHF patients. Methods: Our study population comprised 7 ADHF cohorts. We defined absolute (<1,500 ng/l, <3,000 ng/l, <5,000 ng/l, and <15,000 ng/l) and relative NT-proBNP discharge cut-off levels (>30%, >50%, and >70%). Six-month all-cause mortality after discharge was studied for each level in Cox regression analyses, and compared between elderly (age >75 years) and young patients (age ≤75 years). Thereafter, we compared percentages of elderly and young patients attaining NT-proBNP levels (= attainability). Results: A total of 1,235 patients (59% male, 45% >75 years of age) was studied. Admission levels of NT-proBNP were significantly higher in elderly versus younger patients. The prognostic value of absolute and relative NT-proBNP levels was similar in elderly and young patients. Attainability was significantly lower in elderly patients for all absolute levels and a >50% relative reduction, but not for >30% and >70%. For absolute levels, attainability differences between age groups were decreased to a large extent after correction for admission NT-proBNP and anemia at discharge. For relative levels, attainability differences disappeared after correction for HF etiology and anemia at discharge. Conclusions: In young and elderly ADHF patients, it is not the prognostic value of absolute and relative NT-proBNP levels that is different, but the attainability of these levels that is lower in the elderly. This can largely be attributed to factors other than age.
Language	English
Publishing date	2016-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2705621-1
ISSN	2213-1787 ; 2213-1779
ISSN (online)	2213-1787
ISSN	2213-1779
DOI	10.1016/j.jchf.2016.05.007
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Article ; Online: Competing Risk of Cardiac Status and Renal Function During Hospitalization for Acute Decompensated Heart Failure.

Salah, Khibar / Kok, Wouter E / Eurlings, Luc W / Bettencourt, Paulo / Pimenta, Joana M / Metra, Marco / Verdiani, Valerio / Tijssen, Jan G / Pinto, Yigal M

JACC. Heart failure

2015 Volume 3, Issue 10, Page(s) 751–761

Abstract: Objectives: The aim of this study was to analyze the dynamic changes in renal function in combination with dynamic changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients hospitalized for acute decompensated heart failure (ADHF).: ...

Abstract	Objectives: The aim of this study was to analyze the dynamic changes in renal function in combination with dynamic changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients hospitalized for acute decompensated heart failure (ADHF). Background: Treatment of ADHF improves cardiac parameters, as reflected by lower levels of NT-proBNP. However this often comes at the cost of worsening renal parameters (e.g., serum creatinine, estimated glomerular filtration rate [eGFR], or serum urea). Both the cardiac and renal markers are validated indicators of prognosis, but it is not yet clear whether the benefits of lowering NT-proBNP are outweighed by the concomitant worsening of renal parameters. Methods: This study was an individual patient data analysis assembled from 6 prospective cohorts consisting of 1,232 patients hospitalized for ADHF. Endpoints were all-cause mortality and the composite of all-cause mortality and/or readmission for a cardiovascular reason within 180 days after discharge. Results: A significant reduction in NT-proBNP was not associated with worsening of renal function (WRF) or severe WRF (sWRF). A reduction of NT-proBNP of more than 30% during hospitalization determined prognosis (all-cause mortality hazard ratio [HR]: 1.81; 95% confidence Interval [CI]: 1.32 to 2.50; composite endpoint: HR: 1.36, 95% CI: 1.13 to 1.64), regardless of changes in renal function and other clinical variables. Conclusions: When we defined prognosis, NT-proBNP changes during hospitalization for treatment of ADHF prevailed over parameters for worsening renal function. Severe WRF is a measure of prognosis, but is of lesser value than, and independent of the prognostic changes induced by adequate NT-proBNP reduction. This suggests that in ADHF patients it may be warranted to strive for an optimal decrease in NT-proBNP, even if this induces WRF.
MeSH term(s)	Acute Disease ; Aged ; Aged, 80 and over ; Biomarkers/blood ; Cardio-Renal Syndrome/diagnosis ; Cardio-Renal Syndrome/mortality ; Cardio-Renal Syndrome/therapy ; Cohort Studies ; Confidence Intervals ; Databases, Factual ; Female ; Glomerular Filtration Rate/physiology ; Heart Failure/diagnosis ; Heart Failure/mortality ; Heart Failure/therapy ; Hospital Mortality/trends ; Hospitalization/statistics & numerical data ; Humans ; Kaplan-Meier Estimate ; Kidney Function Tests ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Risk Assessment ; Severity of Illness Index ; Statistics, Nonparametric
Chemical Substances	Biomarkers ; Peptide Fragments ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2015-10
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2705621-1
ISSN	2213-1787 ; 2213-1779
ISSN (online)	2213-1787
ISSN	2213-1779
DOI	10.1016/j.jchf.2015.05.009
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Article ; Online: Challenging the two concepts in determining the appropriate pre-discharge N-terminal pro-brain natriuretic peptide treatment target in acute decompensated heart failure patients: absolute or relative discharge levels?

Stienen, Susan / Salah, Khibar / Eurlings, Luc W M / Bettencourt, Paulo / Pimenta, Joana M / Metra, Marco / Bayes-Genis, Antoni / Verdiani, Valerio / Bettari, Luca / Lazzarini, Valentina / Tijssen, Jan P / Pinto, Yigal M / Kok, Wouter E M

European journal of heart failure

2015 Volume 17, Issue 9, Page(s) 936–944

Abstract: Aims: NT-proBNP is a strong predictor for readmissions and mortality in acute decompensated heart failure (ADHF) patients. We assessed whether absolute or relative NT-proBNP levels should be used as pre discharge treatment target.: Methods and results! ...

Abstract	Aims: NT-proBNP is a strong predictor for readmissions and mortality in acute decompensated heart failure (ADHF) patients. We assessed whether absolute or relative NT-proBNP levels should be used as pre discharge treatment target. Methods and results: Our study population was assembled from seven ADHF cohorts. We defined absolute (<1500, <3000, <5000, and <15 000 ng/L) and relative NT-proBNP targets (>30, >50, and >70%). Population attributable risk fraction (PARF) is the proportion of all-cause 6-month mortality in the population that would be reduced if all patients attain the NT-proBNP target. PARF was determined for each target as well as the percentage of patients attaining the NT-proBNP target. Attainability was investigated by logistic regression analysis. A total of 1266 patients [age 74 (64-80), 60% male] was studied. For every absolute NT-proBNP level, a corresponding percentage reduction was found that resulted in similar PARFs. The highest PARF (∼60-70%) was observed for <1500 or >70%, but attainability was low (27% and 22%, respectively). The strongest predictor for not attaining these targets was admission NT-proBNP. In admission NT-proBNP tertiles, PARFs were significantly different for absolute, but not for relative targets. Conclusion: In an ADHF population, pre-discharge absolute or relative NT-proBNP targets may both be useful as they have similar effects on PARF. However, depending on admission NT-proBNP, absolute targets show varying PARFs, while PARFs for relative targets were similar. A relative target is predicted to reduce mortality consistently across the whole spectrum of ADHF patients, while this is not the case using a single absolute target.
MeSH term(s)	Acute Disease ; Aged ; Aged, 80 and over ; Biomarkers/blood ; Cause of Death/trends ; Disease Progression ; Female ; Follow-Up Studies ; Heart Failure/blood ; Heart Failure/drug therapy ; Heart Failure/mortality ; Hospital Mortality/trends ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Patient Discharge ; Patient Readmission/trends ; Peptide Fragments/blood ; Portugal/epidemiology ; Prognosis ; Prospective Studies ; Protein Precursors ; Risk Assessment/methods ; Survival Rate/trends ; Time Factors
Chemical Substances	Biomarkers ; Peptide Fragments ; Protein Precursors ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2015-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1483672-5
ISSN	1879-0844 ; 1388-9842
ISSN (online)	1879-0844
ISSN	1388-9842
DOI	10.1002/ejhf.320
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Article: Heart failure with preserved systolic function: prevalence and clinical features in a cohort of patients admitted to internal medicine units. The study PRESYF-HF Tuscany.

Biagi, Paolo / Abate, Luigi / Alessandri, Massimo / Bocchini, Salvatore / Verdiani, Valerio / Pettinà, Giuseppe / Nozzoli, Carlo

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

2007 Volume 68, Issue 3, Page(s) 165–169

Abstract: Background: There is uncertainty about the prevalence and clinical characteristics of heart failure (HF) patients with preserved systolic function (PRESYF).: Aim: To analyze the prevalence and clinical characteristics of patients with PRESYF in an ... ...

Abstract	Background: There is uncertainty about the prevalence and clinical characteristics of heart failure (HF) patients with preserved systolic function (PRESYF). Aim: To analyze the prevalence and clinical characteristics of patients with PRESYF in an unselected cohort of subjects consecutively hospitalized for HF. Methods: The study cohort included 338 patients consecutively admitted for HF at 24 Internal Medicine units homogeneously settled in Tuscany area (Italy). We did not have any criteria for exclusion. All patients had an echocardiographic measure of left ventricular ejection fraction (LVEF) within 72 hours from hospital admission. Patients with LVEF > or = 50% were considered to have PRESYF. Results: The patients with PRESYF were 112 (33.1%), those with depressed systolic function (DESYF) 226 (66.9%). In the group PRESYF were prevalent female sex, hypertensive etiology, and elevated BMI. The distribution for classes of age shows a great frequency of PRESYF in the elderly. Conclusion: About one third of patients admitted for HF have a PRESYF. They are different compared to those with DESYF. A correct identification of this form of HF may be important in clinical practice for more targeted therapeutic options and for prognostic implications.
MeSH term(s)	Age Distribution ; Aged ; Aged, 80 and over ; Body Mass Index ; Female ; Heart Failure, Diastolic/blood ; Heart Failure, Diastolic/diagnosis ; Heart Failure, Diastolic/epidemiology ; Heart Failure, Diastolic/physiopathology ; Humans ; Italy/epidemiology ; Length of Stay ; Male ; Prevalence ; Stroke Volume ; Systole/physiology
Language	English
Publishing date	2007-09
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1160940-0
ISSN	1122-0643 ; 1120-0391
ISSN	1122-0643 ; 1120-0391
DOI	10.4081/monaldi.2007.449
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Article ; Online: A novel discharge risk model for patients hospitalised for acute decompensated heart failure incorporating N-terminal pro-B-type natriuretic peptide levels: a European coLlaboration on Acute decompeNsated Heart Failure: ELAN-HF Score.

Salah, Khibar / Kok, Wouter E / Eurlings, Luc W / Bettencourt, Paulo / Pimenta, Joana M / Metra, Marco / Bayes-Genis, Antoni / Verdiani, Valerio / Bettari, Luca / Lazzarini, Valentina / Damman, Peter / Tijssen, Jan G / Pinto, Yigal M

Heart (British Cardiac Society)

2014 Volume 100, Issue 2, Page(s) 115–125

Abstract: Background: Models to stratify risk for patients hospitalised for acute decompensated heart failure (ADHF) do not include the change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels during hospitalisation.: Objective: The aim of our ... ...

Abstract	Background: Models to stratify risk for patients hospitalised for acute decompensated heart failure (ADHF) do not include the change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels during hospitalisation. Objective: The aim of our study was to develop a simple yet robust discharge prognostication score including NT-proBNP for this notorious high-risk population. Design: Individual patient data meta-analyses of prospective cohort studies. Setting: Seven prospective cohorts with in total 1301 patients. Patients: Our study population was assembled from the seven studies by selecting those patients admitted because of clinically validated ADHF, discharged alive, and NT-proBNP measurements available at admission and at discharge. Main outcome measures: The endpoints studied were all-cause mortality and a composite of all-cause mortality and/or first readmission for cardiovascular reason within 180 days after discharge. Results: The model that incorporated NT-proBNP levels at discharge as well as the changes in NT-proBNP during hospitalisation in addition to age ≥75 years, peripheral oedema, systolic blood pressure ≤115 mm Hg, hyponatremia at admission, serum urea of ≥15 mmol/L and New York Heart Association (NYHA) class at discharge, yielded the best C-statistic (area under the curve, 0.78, 95% CI 0.74 to 0.82). The addition of NT-proBNP to a reference model significantly improved prediction of mortality as shown by the net reclassification improvement (62%, p<0.001). A simplified model was obtained from the final Cox regression model by assigning weights to individual risk markers proportional to their relative risks. The risk score we designed identified four clinically significant subgroups. The pattern of increasing event rates with increasing score was confirmed in the validation group (BOT-AcuteHF, n=325, p<0.001). Conclusions: In patients hospitalised for ADHF, the addition of the discharge NT-proBNP values as well as the change in NT-proBNP to known risk markers, generates a relatively simple yet robust discharge risk score that importantly improves the prediction of adverse events.
MeSH term(s)	Acute Disease ; Aged ; Aged, 80 and over ; Cohort Studies ; Disease Progression ; Female ; Heart Failure/blood ; Heart Failure/diagnosis ; Heart Failure/mortality ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Patient Discharge ; Patient Readmission/statistics & numerical data ; Peptide Fragments/blood ; Prognosis ; Prospective Studies ; Risk Assessment/methods
Chemical Substances	Peptide Fragments ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2014-01
Publishing country	England
Document type	Journal Article ; Meta-Analysis
ZDB-ID	1303417-0
ISSN	1468-201X ; 1355-6037
ISSN (online)	1468-201X
ISSN	1355-6037
DOI	10.1136/heartjnl-2013-303632
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In stock of ZB MED Cologne/Königswinter

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Kategorien

Order via subito

More links

Kategorien

Order via subito

Full text online

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Kategorien

In stock of ZB MED Cologne/Königswinter

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More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito