B-type natriuretic peptide is an important prognostic marker in heart failure. However, there are limited data for its value in non-cardiac intensive care unit patients, namely regarding long-term prognosis. We investigated the long-term prognostic value of BNP in a cohort of critically ill patients. This was a prospective and observational study, conducted in a tertiary university hospital 20-bed intensive care unit. We included 103 mechanically- ventilated patients admitted for a noncardiac primary diagnosis; B-type natriuretic peptide samples were obtained on admission. A mean 14 (3-30) month follow up was available in 96.1% of patients who were discharged from hospital. Mean age was 60.7±19.0 years and mean APACHE II score was 16.2±7.2. APACHE II score and renal dysfunction increased with rising B-type natriuretic peptide, with more than 60% of patients having Btype natriuretic peptide levels of 100 pg/mL or over; echocardiography-derived left ventricular ejection fraction was lower in patients with higher B-type natriuretic peptide (P < 0.001). Long-term survivors had lower median B-type natriuretic peptide values (117.5[2-1668] pg/mL) compared with intensive care unit non-survivors (191.0[5-4945] pg/mL), P<0.001. After adjustment to APACHE II score, B-type natriuretic peptide levels of 300 pg/mL or over were independently associated with long-term mortality (odds-ratio 4.1 [95% CI 1.45-11.5], P=0.008). We conclude that in an unselected cohort of intensive care unit patients, admission B-type natriuretic peptide is frequently elevated, even without clinically apparent acute heart disease, and is a strong independent predictor of long-term mortality.
BNP, critical illness, prognosis, mortality.
Rui Baptista Cardiology Department, Coimbra University Hospital and Medical School Praceta Mota Pinto, 3000-001 Coimbra, Portugal. Tel: + 351.918523940. E-mail: firstname.lastname@example.org
We are indebted to the ICU
nursing staff, for substantial help in blood sample
withdrawal and processing.
Share this Article
Related Content In Heart Failure
49/Multi-disciplinary heart failure- Device clinic improves management of heart failure patients following complex device implantatio
European Journal of Arrhythmia & Electrophysiology. 2021;7(Suppl. 1):abstr49
Introduction: Complex device therapy (CDT) [cardiac resynchronisation therapy pacemaker or defibrillator (CRTP or CRTD) and implantable cardioverter defibrillator (ICD)], is recommended in patients with heart failure (HF) with severe left ventricular systolic dysfunction if they are still symptomatic despite optimisation HF medication. Several patients however, will only tolerate optimal doses of these drugs after CDT, […]
47/Association between very high NT-proBNP levels, and haemoglobin and ferritin
European Journal of Arrhythmia & Electrophysiology. 2021;7(Suppl. 1):abstr47
Introduction: The adverse prognosis in heart failure (HF) correlates with both NT-proBNP and high-sensitivity CRP levels. The latter indicates a greater underlying inflammatory process in more severe heart failure. This inflammatory response is also evidenced by elevated ferritin (acute phase reactant) and reduced haemoglobin (bone marrow suppression) amongst these patients. It is unclear if there […]
Management of Atrial Fibrillation in Recipients of Cardiac Resynchronization Therapy
European Journal of Arrhythmia & Electrophysiology. 2021;7(1):19-25 DOI: https://doi.org/10.17925/EJAE.2021.7.1.19
Atrial fibrillation (AF) and heart failure (HF) often co-exist. The incidence of AF is estimated to reach 45% of patients with HF and rises with the severity of HF symptoms, from about 5% of patients in the New York Heart Association (NYHA) class I to 50% in NYHA class IV.1–4 Consistently, the incidence of AF […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!