Serum Blood Urea Nitrogen and Plasma Brain Natriuretic Peptide and Low Diastolic Blood Pressure Predict Cardiovascular Morbidity and Mortality Following Discharge in Acute Decompensated Heart Failure Patients
Serum Blood Urea Nitrogen and Plasma Brain Natriuretic Peptide and Low Diastolic Blood Pressure Predict Cardiovascular Morbidity and Mortality Following Discharge in Acute Decompensated Heart Failure Patients
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DOI：
10.1253/circj.cj-12-0040
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发表时间：
2012-10-01
影响因子：
3.3
通讯作者：
Kitakaze, Masafumi
中科院分区：
文献类型：
--
作者：
Chen, Chun-Yen;Yoshida, Akemi;Kitakaze, Masafumi
背景：心力衰竭（HF）患者心血管（CV）死亡和再住院的风险很高。因此，本研究的目的是调查心血管死亡和急性失代偿性心力衰竭 (ADHF) 再次住院的预测因素。 方法和结果：对 2008 年至 2009 年间因 ADHF 住院的 225 名年龄 67.2 +/- 15.2 岁的患者进行了随访，其中包括 134 名男性 (59.6%)。出院后，检查临床参数和心血管事件（即心血管死亡或心力衰竭再次住院）之间的关系。随访持续至2011年4月30日。再住院最重要的预测因素是血清血尿素氮（BUN；调整后的风险比[HR]，1.02；95%置信区间[CI]：1.00-1.03，P=0.01）、血浆脑钠尿肽（BNP；调整后的HR，1.85；95% CI： 1.12-3.04，P=0.02）和舒张压（DBP；调整后的 HR，0.97；95% CI：0.94-1.00，P=0.049）。 CV 死亡率的唯一预测因素是高 BUN（调整后 HR，1.05；95% CI：1.01-1.09，P=0.01）。结论：高血清 BUN (>= 22.5 mg/dl)、高血浆 BNP (>= 250 pg/ml) 和低 DBP (< 60 mmHg) 可预测因 ADHF 住院患者的 CV 事件。这些因素可以识别心血管事件的高危患者，并为管理心力衰竭提供治疗目标。 （Circ J 2012；76：2372-2379）
Background: Patients with heart failure (HF) have a high risk of cardiovascular (CV) death and re-hospitalization. The purpose of the present study was therefore to investigate predictors of CV death and re-hospitalization for acute decompensated HF (ADHF).Methods and Results: A total of 225 patients aged 67.2 +/- 15.2 years, including 134 men (59.6%), who were hospitalized for ADHF between 2008 and 2009, were followed up. After discharge, the relationship between clinical parameters and CV events (ie, CV death or re-hospitalization for HF) was examined. Follow-up was continued until 30 April 2011. The most important predictors of re-hospitalization were serum blood urea nitrogen (BUN; adjusted hazard ratio [HR], 1.02; 95% confidence interval [CI]: 1.00-1.03, P=0.01), plasma brain natriuretic peptide (BNP; adjusted HR, 1.85; 95% CI: 1.12-3.04, P=0.02), and diastolic blood pressure (DBP; adjusted HR, 0.97; 95% CI: 0.94-1.00, P=0.049). The only predictor of CV mortality was a high BUN (adjusted HR, 1.05; 95% CI: 1.01-1.09, P=0.01).Conclusions: High serum BUN (>= 22.5 mg/dl), high plasma BNP (>= 250 pg/ml), and low DBP (< 60 mmHg) predict CV events in patients hospitalized for ADHF. These factors may identify high-risk patients for CV events and provide therapeutic targets for managing HF. (Circ J 2012; 76: 2372-2379)