ABSTRACT
Fundamentos y objetivo: Los péptidos natriuréticos (PN) han demostrado su utilidad en la insuficiencia cardiaca (IC) y algunos trastornos de la circulación pulmonar. El presente trabajo tiene por objeto conocer la utilidad de la fracción aminoterminal del péptido natriurético cerebral (NT-proBNP) como marcador pronóstico en pacientes con enfermedad pulmonar crónica reagudizada, sin semiología clínica de IC. Pacientes y método: Estudio prospectivo y observacional. Se incluyeron de forma consecutiva 192 pacientes con enfermedad pulmonar crónica ingresados por descompensación de su enfermedad respiratoria. Se determinó la concentración sanguínea de NT-proBNP en todos ellos y se realizó posteriormente un seguimiento durante los 6 meses posteriores al ingreso para detectar reingresos, prescripción de diuréticos, oxigenoterapia o muerte.Resultados: El 6,3% de los pacientes fallecieron, en un 22,9% se prescribió oxigenoterapia, en un 18,2% diuréticos y el 21,9% reingresó al menos en una ocasión durante el período de seguimiento de 6 meses. La concentración media de NT-proBNP fue de 1180pg/ml. Concentraciones de NT-proBNP superiores a 500pg/ml (odds ratio [OR] 11,0, intervalo de confianza del 95% [IC 95%] 1,3986,99) y de 350pg/ml fueron predictoras de mortalidad y prescripción de diurético (OR 2,83; IC 95% 1,166,86), respectivamente. Conclusiones: El NT-proBNP podría ser un marcador pronóstico en pacientes con enfermedad pulmonar crónica, identificando a aquellos con especial riesgo de fallecer o más probabilidad de desarrollar una disfunción ventricular sintomática (AU)
Background and objective: Brain natriuretic peptide (BNP) is produced and released mainly from ventricles. BNP has been shown to be useful in diagnosis and prognosis in heart failure and some pulmonary conditions. The aim of this study is to analyse whether NT-proBNP has a prognostic value in chronic pulmonary patients without overt heart failure. Patient and method: We conducted an observational and prospective study. We included 192 patients admitted to the Internal Medicine Departments of Hospital Clinico Lozano Blesa (Zaragoza, Spain) and Virgen de la Luz (Cuenca, Spain) with acute exacerbation of pulmonary disease. Blood samples were taken to determine NT-proBNP concentrations. All patients were followed for 6 months after admission.Results: 6,3% of patients died, 22,9% were prescribed with home oxygen-therapy, 18,2% received a diuretic prescription and 21,9% were re-admitted at least once during the follow-up period. Mean NT-proBNP was 1180pg/ml. A concentration above 500pg/ml and 350pg/ml of NT-proBNP was useful to predict mortality and diuretic prescription respectively.Conclusions: Among patients with acute exacerbations of chronic pulmonary disease, NT-proBNP could be a prognostic factor to identify those at risk of death or worst clinical development (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Natriuretic Peptide, Brain/blood , Pulmonary Disease, Chronic Obstructive/blood , Biomarkers , Prospective Studies , Natriuretic Peptide, Brain , Pulmonary Disease, Chronic Obstructive/drug therapy , Pulmonary Disease, Chronic Obstructive/mortality , Heart Failure/blood , Prognosis , Mortality , Oxygen Inhalation Therapy , Diuretics/therapeutic useABSTRACT
BACKGROUND AND OBJECTIVE: Brain natriuretic peptide (BNP) is produced and released mainly from ventricles. BNP has been shown to be useful in diagnosis and prognosis in heart failure and some pulmonary conditions. The aim of this study is to analyse whether NT-proBNP has a prognostic value in chronic pulmonary patients without overt heart failure. PATIENT AND METHOD: We conducted an observational and prospective study. We included 192 patients admitted to the Internal Medicine Departments of Hospital Clinico "Lozano Blesa" (Zaragoza, Spain) and "Virgen de la Luz" (Cuenca, Spain) with acute exacerbation of pulmonary disease. Blood samples were taken to determine NT-proBNP concentrations. All patients were followed for 6 months after admission. RESULTS: 6,3% of patients died, 22,9% were prescribed with home oxygen-therapy, 18,2% received a diuretic prescription and 21,9% were re-admitted at least once during the follow-up period. Mean NT-proBNP was 1180pg/ml. A concentration above 500pg/ml and 350pg/ml of NT-proBNP was useful to predict mortality and diuretic prescription respectively. CONCLUSIONS: Among patients with acute exacerbations of chronic pulmonary disease, NT-proBNP could be a prognostic factor to identify those at risk of death or worst clinical development.
Subject(s)
Bronchitis, Chronic/blood , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Pulmonary Disease, Chronic Obstructive/blood , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prognosis , Prospective StudiesSubject(s)
Arthritis, Infectious/microbiology , Cholecystitis/microbiology , Pneumococcal Infections , Aged , Humans , MaleABSTRACT
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No disponible
Subject(s)
Humans , Male , Aged , Cholecystitis/complications , Arthritis, Infectious/complications , Streptococcus pneumoniae/isolation & purification , Streptococcal Infections/complicationsSubject(s)
Cytomegalovirus Infections/diagnosis , Meningoencephalitis/diagnosis , Aged , Cytomegalovirus/isolation & purification , Cytomegalovirus Infections/cerebrospinal fluid , DNA, Viral/cerebrospinal fluid , Epilepsy, Tonic-Clonic/etiology , Female , Humans , Immunocompetence , Meningoencephalitis/cerebrospinal fluid , Meningoencephalitis/virologyABSTRACT
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