File(s) under permanent embargo
Brain natriuretic peptide in heart failure: an improving prognosis?
journal contribution
posted on 2023-06-07, 14:53 authored by David Crook, Helen SmithAims Chronic heart failure is a common condition with high mortality. Accurate diagnosis in primary care is difficult. Elevated B-type natriuretic peptide (BNP) is associated with left ventricular systolic dysfunction and increased mortality. Prognostic scoring systems using BNP may help to stratify risk in primary care patients. The aim of this research was to establish the independent variables which predict mortality in a primary care population-prescribed loop diuretics and to generate and validate a scoring system for heart failure in general practice. Methods and results Five hundred and thirty-two patients were followed up for a mean of 6.4 years after attending a research clinic for clinical assessment, electrocardiogram (ECG), echocardiography, and BNP. Multivariate analysis was used to establish independent prognostic variables and to generate a prognostic scoring system. The score generated was [0.50xBNP+5xage+50x(CVA+sex+diabetes+ECG)]. The cut-off scores for risk groups were; 25th percentile, 411; 50th percentile, 475; 75th percentile, 524; Harrell's c=0.75. Conclusion Developing prognostic scoring systems provides a means of risk stratifying patients without relying on a single cut-off diagnostic value for BNP. Further validation of such scoring systems may improve future management of community heart failure patients.
History
Publication status
- Published
File Version
- Published version
Journal
European Heart JournalISSN
0195-668XPublisher
Oxford University PressExternal DOI
Issue
11Volume
26Page range
1052-1053Department affiliated with
- Primary Care and Public Health Publications
Full text available
- No
Peer reviewed?
- Yes