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Reductions in N-Ter...
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Savarese, GianluigiKarolinska Institutet
(författare)
Reductions in N-Terminal Pro-Brain Natriuretic Peptide Levels Are Associated With Lower Mortality and Heart Failure Hospitalization Rates in Patients With Heart Failure With Mid-Range and Preserved Ejection Fraction
- Artikel/kapitelEngelska2016
Förlag, utgivningsår, omfång ...
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LIPPINCOTT WILLIAMS & WILKINS,2016
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Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:liu-133390
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-133390URI
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https://doi.org/10.1161/CIRCHEARTFAILURE.116.003105DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:134653040URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Funding Agencies|County Council of Stockholm; Swedish Heart and Lung Foundation; Swedish Research Council
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Background-In heart failure with mid-range ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF), feasible surrogate end points are needed for phase II trials. The aim was to assess whether a reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with improved mortality/morbidity in an unselected population of HFmrEF and HFpEF patients. Methods and Results-In the Swedish Heart Failure Registry, HFmrEF (EF=40%-49%) and HFpEF (EF=50%) patients reporting at least 2 consecutive outpatient NT-proBNP assessments were prospectively studied. Associations between reduction in NT-proBNP and overall mortality, HF hospitalization, and their composite were assessed by multivariable Cox regressions, with NT-proBNP changes modeled as binary (decrease/increase) or quantitative predictor by restricted cubic splines. In 650 patients, at a median of 7 months between the 2 measurements of NT-proBNP and over a median followup of 1.65 years, 361 patients (55%) showed a reduction and 289 patients (45%) an increase in NT-proBNP. Change in NT-proBNP was associated with risk of outcomes. Fifty-seven patients (16%) who decreased their NT-proBNP versus 78 patients (27%) who increased it died from any cause (adjusted hazard ratio=0.53; 95% confidence interval=0.36-0.77), 61 (17%) versus 86 (30%) were hospitalized for HF (hazard ratio=0.41; 95% confidence interval=0.29-0.60), and 96 (27%) versus 125 (43%) reported the composite outcome (hazard ratio=0.46; 95% confidence interval=0.34-0.62). These findings were replicated in HFmrEF and HFpEF separately. Conclusions-In HFmrEF and HFpEF during routine care, decreases in NT-proBNP were associated with improved mortality and morbidity. Studies to determine whether NT-proBNP changes in response to therapy predict drug efficacy are needed.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Hage, CamillaKarolinska Institutet
(författare)
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Orsini, NicolaKarolinska Institutet
(författare)
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Dahlström, UlfLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)ulfda85
(författare)
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Perrone-Filardi, PasqualeUniversity of Naples Federico II, Italy
(författare)
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Rosano, Giuseppe M. C.St Georges University, England; IRCCS San Raffaele Pisana, Italy
(författare)
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Lund, Lars H.Karolinska Institutet
(författare)
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Karolinska InstitutetAvdelningen för kardiovaskulär medicin
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Circulation Heart Failure: LIPPINCOTT WILLIAMS & WILKINS9:111941-32891941-3297
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