The Prognostic Value of B-Type Natriuretic Peptide in Patients With Cardiac Sarcoidosis Without Heart Failure: Insights From ILLUMINATE-CS.
The Prognostic Value of B-Type Natriuretic Peptide in Patients With Cardiac Sarcoidosis Without Heart Failure: Insights From ILLUMINATE-CS.
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DOI：
10.1161/jaha.122.025803
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发表时间：
2022-12-20
影响因子：
5.4
通讯作者：
Minamino, Tohru
中科院分区：
文献类型：
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作者：
Miyakuni, Shota;Maeda, Daichi;Matsue, Yuya;Yoshioka, Kenji;Dotare, Taishi;Sunayama, Tsutomu;Nabeta, Takeru;Naruse, Yoshihisa;Kitai, Takeshi;Taniguchi, Tatsunori;Tanaka, Hidekazu;Okumura, Takahiro;Baba, Yuichi;Matsumura, Akihiko;Minamino, Tohru
BNP（B 型利钠肽）对无明显心力衰竭的心脏结节病患者的预后作用尚不清楚。这是对 ILLUMINATE-CS（日本心脏结节病患者的治疗和预后说明）的事后分析，这是一项评估心脏结节病临床特征和预后的多中心、回顾性和观察性研究。我们分析了诊断时没有明显心力衰竭的心脏结节病患者。研究了基线 BNP 水平与预后之间的关联。主要终点是全因死亡、心力衰竭住院和致命性室性心律失常的综合终点。总共对 238 名患者（61.0±11.1 岁，37% 男性）进行了分析，并在中位随访期 3.0 年（四分位距，1.7-5.8）内观察到了 61 个主要终点。高 BNP（BNP 高于 BNP 中位值）的患者比低 BNP 值的患者年龄更大，肾功能和左心室射血分数较低。 Kaplan-Meier 曲线分析表明，高 BNP 水平与主要终点的高发生率显着相关（对数秩 P=0.004），并且这种相关性甚至在多变量 Cox 回归中也得以保留（风险比，2.06 [95% CI，1.19-3.55]；P=0.010）。对数转换的 BNP 作为连续变量与主要终点相关（风险比，2.12 [95% CI，1.31–3.43]；P=0.002）。高基线 BNP 水平是诊断时无心力衰竭的心脏结节病患者未来不良事件的独立预测因子。网址：https://www.umin.ac.jp/english/；唯一标识符：UMIN-CTR：UMIN000034974。
The prognostic role of BNP (B‐type natriuretic peptide) in patients with cardiac sarcoidosis without evident heart failure is unknown. This is a post hoc analysis of ILLUMINATE‐CS (Illustration of the Management and Prognosis of Japanese Patients With Cardiac Sarcoidosis), a multicenter, retrospective, and observational study that evaluated the clinical characteristics and prognosis of cardiac sarcoidosis. We analyzed patients with cardiac sarcoidosis without evident heart failure at the time of diagnosis. The association between baseline BNP levels and prognosis was investigated. The primary end point was the combined end point of all‐cause death, heart failure hospitalization, and fatal ventricular arrhythmia. In total, 238 patients (61.0±11.1 years, 37% men) were analyzed, and 61 primary end points were observed during a median follow‐up period of 3.0 (interquartile range, 1.7–5.8) years. Patients with high BNP (BNP above the median value of BNP) were older and had a lower renal function and left ventricular ejection fraction than those with low BNP values. Kaplan–Meier curve analysis indicated that high BNP levels were significantly associated with a high incidence of primary end points (log‐rank P=0.004), and this association was retained even in multivariable Cox regression (hazard ratio, 2.06 [95% CI, 1.19–3.55]; P=0.010). Log‐transformed BNP as a continuous variable was associated with the primary end point (hazard ratio, 2.12 [95% CI, 1.31–3.43]; P=0.002). High baseline BNP level was an independent predictor of future adverse events in patients with cardiac sarcoidosis without heart failure at the time of diagnosis. URL: https://www.umin.ac.jp/english/; Unique Identifier: UMIN‐CTR: UMIN000034974.