Sökning: id:"swepub:oai:lup.lub.lu.se:cfc77a7b-4204-42d1-8e50-31c2adbf7e1b" >
Prediction of clini...
Prediction of clinical outcome in patients treated with cardiac resynchronization therapy - the role of NT-ProBNP and a combined response score
-
- Bakos, Z. (författare)
- Lund University,Lunds universitet,Arrhytmias and Cardiac Device treatment,Forskargrupper vid Lunds universitet,Lund University Research Groups,Massachusetts General Hospital,Skåne University Hospital
-
- Chatterjee, N. C. (författare)
- Massachusetts General Hospital
-
- Reitan, C. (författare)
- Lund University,Lunds universitet,Arrhytmias and Cardiac Device treatment,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital
-
visa fler...
-
- Singh, J. P. (författare)
- Massachusetts General Hospital
-
- Borgquist, R. (författare)
- Lund University,Lunds universitet,Arrhytmias and Cardiac Device treatment,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital
-
visa färre...
-
(creator_code:org_t)
- 2018-04-24
- 2018
- Engelska.
-
Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 18:1
- Relaterad länk:
-
http://dx.doi.org/10... (free)
-
visa fler...
-
https://bmccardiovas...
-
https://lup.lub.lu.s...
-
https://doi.org/10.1...
-
visa färre...
Abstract
Ämnesord
Stäng
- Background: Cardiac resynchronization therapy (CRT) is an established therapy for appropriately selected patients with heart failure. Response to CRT has been heterogeneously defined using both clinical and echocardiographic measures, with poor correlation between the two. Methods: The study cohort was comprised of 202 CRT-treated patients and CRT response was defined at 6 months post-implant. Echocardiographic response (E+) was defined as a reduction in LVESV ≥ 15%, clinical response as an improvement of ≥ 1 NYHA class (C+), and biomarker response as a ≥ 25% reduction in NT-proBNP(B+). The association of response measures (E+, B+, C+; response score range 0-3) and clinical endpoints at 3 years was assessed in landmarked Cox models. Results: Echo and clinical responders demonstrated greater declines in NT-proBNP than non-responders (median [E+/B+]: -52%, [E+]: -27%, [C+]: -39% and [E-/C-]: -13%; p = 0.01 for trend). Biomarker (HR 0.43 [95% CI: 0.22-0.86], p = 0.02) and clinical (HR 0.40 [0.23-0.70] p = 0.001) response were associated with a significantly reduced risk of the primary endpoint. When integrating each response measure into a composite score, each 1 point increase was associated with a 31% decreased risk for a composite endpoint of mortality, LVAD, transplant and HF hospitalization (HR 0.69 [95% CI: 0.50-0.96], p = 0.03), and a 52% decreased risk of all-cause mortality (HR 0.48 [95% CI: 0.26-0.89], p = 0.02). Conclusion: Serial changes in NT-proBNP are associated with clinical outcomes following CRT implant. Integration of biomarker, clinical, and echocardiographic response may discriminate CRT responders versus non-responders in a clinically meaningful way, and with higher accuracy.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Cardiac response
- Cardiac resynchronization therapy
- Dilated cardiomyopathy
- Heart failure
- NT-proBNP
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
Hitta via bibliotek
Till lärosätets databas