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Multicenter Study
. 2019 Sep 5;9(9):e029885.
doi: 10.1136/bmjopen-2019-029885.

N-terminal pro-B-type natriuretic peptide and outcomes in type B aortic dissection in China: a retrospective multicentre study

Changjun Luo  1 , Jianwei Zhou  2 , Si Xiong  1 , Zhongqiang Kang  1 , Jing Zhang  1 , Yifan Sun  1 , Biyun Qin  1 , Kuaifa Fang  3
Affiliations
Multicenter Study

N-terminal pro-B-type natriuretic peptide and outcomes in type B aortic dissection in China: a retrospective multicentre study

Changjun Luo et al. BMJ Open. .

Abstract

Objectives: N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is an unfavourable factor responsible for poor outcomes in the cardiovascular diseases. Nevertheless, the prognostic role of NT-pro-BNP in type B aortic dissection (TBAD) remains unclear. The aim of the current study was to investigate the relationship between NT-pro-BNP levels and in-hospital and long-term adverse prognosis in patients with TBAD.

Design: A retrospective multicentre study.

Setting: Liutie Central Hospital, Nanfang Hospital and Huiyang Hospital in China.

Participants: A total of 657 consecutive patients with TBAD were enrolled in the study. NT-pro-BNP was measured at admission and included patients were divided into three groups according to the tertiles of NT-pro-BNP (pg/mL): <95 (n=220), 95-312 (n=218) and >312 (n=219).

Primary and secondary outcome measures: Long-term mortality and in-hospital major adverse clinical events.

Results: Overall, in-hospital death occurred in 27 patients (4.1%), which was significantly higher in upper tertiles of NT-pro-BNP (0.5% vs 4.1% vs 7.8%, p<0.001). The incident of in-hospital major adverse clinical events increased along with higher NT-pro-BNP (1.4% vs 11.5% vs 15.5%, p<0.001). NT-pro-BNP >210 pg/mL had 81.5% sensitivity and 58.6% specificity for predicting in-hospital death (area under the curve= 0.774, 95% CI 0.692 to 0.855; p<0.001). After a median of 3.1 years of follow-up, 97 (14.8%) patients died. The Kaplan-Meier analysis indicated that the long-term cumulative mortality was higher in patients with NT-pro-BNP >210 pg/mL compared with patients with NT-pro-BNP ≤210 pg/mL (log-rank=26.92, p<0.001). In multivariable Cox survival modelling, NT-pro-BNP >210 pg/mL was independently associated with long-term death (adjusted HR 2.47, 95% CI 1.45 to 4.22, p=0.001).

Conclusions: NT-pro-BNP resulted as an independent predictor of adverse prognosis in patients with TBAD, thus could be used as a potential risk-stratification tool.

Keywords: Brain natriuretic peptide; aortic dissection; prognosis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Prevalence of in-hospital events. MACEs, major adverse clinical events.
Figure 2
Figure 2
ROC curves of NT-pro-BNP and D-dimer for predicting in-hospital mortality. NT-pro-BNP, N-terminal pro-B-type natriuretic peptide; ROC, receiver operating characteristic.
Figure 3
Figure 3
Cumulative mortality in the entire study cohort according to NT-pro-BNP cut-off. NT-pro-BNP, N-terminal pro-B-type natriuretic peptide.
See this image and copyright information in PMC

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References

    1. Erbel R, Aboyans V, Boileau C, et al. . Esc guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The task force for the diagnosis and treatment of aortic diseases of the European Society of cardiology (ESC). Eur Heart J 2014;2014:2873–926. - PubMed
    1. Nienaber CA, Clough RE. Management of acute aortic dissection. Lancet 2015;385:800–11. 10.1016/S0140-6736(14)61005-9 - DOI - PubMed
    1. Durham CA, Cambria RP, Wang LJ, et al. . The natural history of medically managed acute type B aortic dissection. J Vasc Surg 2015;61:1192–9. 10.1016/j.jvs.2014.12.038 - DOI - PubMed
    1. Nienaber CA, Kische S, Rousseau H, et al. . Endovascular repair of type B aortic dissection: long-term results of the randomized investigation of stent grafts in aortic dissection trial. Circ Cardiovasc Interv 2013;6:407–16. 10.1161/CIRCINTERVENTIONS.113.000463 - DOI - PubMed
    1. Fattori R, Montgomery D, Lovato L, et al. . Survival after endovascular therapy in patients with type B aortic dissection: a report from the International registry of acute aortic dissection (IRAD). JACC Cardiovasc Interv 2013;6:876–82. 10.1016/j.jcin.2013.05.003 - DOI - PubMed

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