Clinical utility of NT-proBNP levels in late heart transplantation patients

被引：8
作者：
Avello, Noelia [1 ]
Prieto, Belen [1 ]
Molina, Beatriz D. [2 ]
Rodriguez-Lambert, Jose L. [2 ]
Alvarez, Francisco V. [1 ,3 ]
机构：
[1] Hosp Univ Cent Asturias, Serv Bioquim Clin, Oviedo 33006, Spain
[2] Hosp Univ Cent Asturias, Serv Cardiol, Oviedo 33006, Spain
[3] Univ Oviedo, Dept Bioquim & Biol Mol, Oviedo, Spain
来源：
CLINICA CHIMICA ACTA | 2010年 / 411卷 / 3-4期
关键词：
Heart transplantation; Natriuretic peptides; Rejection; Prognosis; BRAIN NATRIURETIC PEPTIDE; CARDIAC ALLOGRAFT-REJECTION; INTERNATIONAL-SOCIETY; LUNG-TRANSPLANTATION; BNP; DIAGNOSIS; FAILURE; MORTALITY; VASCULOPATHY; SURVIVAL;
D O I：
10.1016/j.cca.2009.10.021
中图分类号：
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号：
1001 ;
摘要：
Background: The present work was aimed to describe NT-proBNP levels in heart transplant patients after the first year postsurgery. Methods: NT-proBNP concentration was measured in 1231 samples from 142 patients when a routine four-month follow-up was carried out, including other biochemical and clinical examinations. Endomyocardial biopsies were performed only upon clinical suspicion of acute rejection. Results: NT-proBNP concentrations were not significantly correlated to post-transplantation time, though differences were observed according to clinical symptoms (Kruskal-Wallis test, p<0.001). Although multivariate analysis revealed statistically significant association between NT-proBNP concentration and some qualitative (cardiac allograft vasculopathy-CAV-, sex, diabetes) and quantitative (creatinine, hematocrit, age) variables, only moderately relevant contribution was observed for creatinine and CAV. Patients with rejection showed noticeable increases in serum NT-proBNP concentrations. above more than 2.5 times the reference change value (97%). NT-proBNP concentrations higher than 1000 ng/L increased in 3.5 times (95%CI: 2.4-5) the risk of death in less than one year. Conclusions: After the first year from surgery, NT-proBNP concentrations were not associated to post-transplantation time and NT-proBNP could be a useful diagnostic marker for rejection, whenever serial measurements are made. A NT-proBNP cutoff value of 1000 ng/L was identified for classifying patients at risk of death after one year. (c) 2009 Elsevier B.V. All rights reserved.
引用
收藏
页码：161 / 166
页数：6
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