Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study
Objectives Acute type A aortic dissection is a life-threatening cardiovascular disease commonly seen in emergency department, resulting in substantial mortality and morbidity. We aimed to investigate the prognostic value of N-terminal pro-B type natriuretic peptide (NT-proBNP) among this critically...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e093757.full |
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| author | Rui Zhang Hao Wang Chenxi Song Rui Fu Kefei Dou Shuai Liu Qianqian Liu Xiaohui Bian Weida Liu Chengang Zhu Jingjing Gao Sheng Yuan Xinming Cui Sijia Qin Yumeng Li |
| author_facet | Rui Zhang Hao Wang Chenxi Song Rui Fu Kefei Dou Shuai Liu Qianqian Liu Xiaohui Bian Weida Liu Chengang Zhu Jingjing Gao Sheng Yuan Xinming Cui Sijia Qin Yumeng Li |
| author_sort | Rui Zhang |
| collection | DOAJ |
| description | Objectives Acute type A aortic dissection is a life-threatening cardiovascular disease commonly seen in emergency department, resulting in substantial mortality and morbidity. We aimed to investigate the prognostic value of N-terminal pro-B type natriuretic peptide (NT-proBNP) among this critically ill population.Design The design of this study was a retrospective cohort study.Setting The study population was recruited in the Emergency Department of Fuwai hospital in China from 2018 to 2020.Participants We consecutively enrolled 829 patients with acute type A aortic dissection and measurable baseline NT-proBNP.Primary outcome The primary endpoint was 1-year all-cause death.Results Based on tertiles of NT-proBNP (pg/mL), patients were stratified into low (≤150.3, n=276), intermediate (150.3–667.6, n=277) and high (>667.6, n=276) NT-proBNP groups. Compared with patients with low NT-proBNP, the Kaplan-Meier estimates for primary 1-year mortality were higher in intermediate (32.5% vs 18.1%; HR 1.91, 95% CI 1.35 to 2.69) and high (42.0% vs 18.1%; HR 2.56, 95% CI 1.84 to 3.57) NT-proBNP groups, respectively. After multivariable regression adjusted for confounders, NT-proBNP tertiles were independent predictors for 1-year mortality (adjusted HR for intermediate group 1.52, 95% CI 1.02 to 2.27; adjusted HR for high group 2.17, 95% CI 1.41 to 3.32). Notably, the predictive performance of NT-proBNP for 1-year mortality was greater in patients receiving surgery than conservative treatment (between-cohorts difference in area under the curve 0.13, Delong’s test p=0.04).Conclusion NT-proBNP provides incremental prognostic information for mortality in patients with acute type A aortic dissection who underwent surgical repairment, which could aid in risk stratification as a pragmatic and versatile biomarker in this critically ill population while having limited prognostic value for those receiving conservative treatment. |
| format | Article |
| id | doaj-art-8b8faa0ae8de4d63ae3a489e2a3b45f4 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-8b8faa0ae8de4d63ae3a489e2a3b45f42025-01-30T08:05:11ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-093757Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort studyRui Zhang0Hao Wang1Chenxi Song2Rui Fu3Kefei Dou4Shuai Liu5Qianqian Liu6Xiaohui Bian7Weida Liu8Chengang Zhu9Jingjing Gao10Sheng Yuan11Xinming Cui12Sijia Qin13Yumeng Li143 State Key Laboratory of Cardiovascular Disease, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China5 State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China6 China Academy of Traditional Chinese Medicine Guang `anmen Hospital Baoding Hospital, Baoding, China1 Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China7 Jixi Traditional Chinese Medicine Hospital, Jixi, China8 Jinzhong Second People`s Hospital, Jinzhong, China9 China Academy of Chinese Medical Sciences Guanganmen Hospital, Xicheng District, ChinaObjectives Acute type A aortic dissection is a life-threatening cardiovascular disease commonly seen in emergency department, resulting in substantial mortality and morbidity. We aimed to investigate the prognostic value of N-terminal pro-B type natriuretic peptide (NT-proBNP) among this critically ill population.Design The design of this study was a retrospective cohort study.Setting The study population was recruited in the Emergency Department of Fuwai hospital in China from 2018 to 2020.Participants We consecutively enrolled 829 patients with acute type A aortic dissection and measurable baseline NT-proBNP.Primary outcome The primary endpoint was 1-year all-cause death.Results Based on tertiles of NT-proBNP (pg/mL), patients were stratified into low (≤150.3, n=276), intermediate (150.3–667.6, n=277) and high (>667.6, n=276) NT-proBNP groups. Compared with patients with low NT-proBNP, the Kaplan-Meier estimates for primary 1-year mortality were higher in intermediate (32.5% vs 18.1%; HR 1.91, 95% CI 1.35 to 2.69) and high (42.0% vs 18.1%; HR 2.56, 95% CI 1.84 to 3.57) NT-proBNP groups, respectively. After multivariable regression adjusted for confounders, NT-proBNP tertiles were independent predictors for 1-year mortality (adjusted HR for intermediate group 1.52, 95% CI 1.02 to 2.27; adjusted HR for high group 2.17, 95% CI 1.41 to 3.32). Notably, the predictive performance of NT-proBNP for 1-year mortality was greater in patients receiving surgery than conservative treatment (between-cohorts difference in area under the curve 0.13, Delong’s test p=0.04).Conclusion NT-proBNP provides incremental prognostic information for mortality in patients with acute type A aortic dissection who underwent surgical repairment, which could aid in risk stratification as a pragmatic and versatile biomarker in this critically ill population while having limited prognostic value for those receiving conservative treatment.https://bmjopen.bmj.com/content/15/1/e093757.full |
| spellingShingle | Rui Zhang Hao Wang Chenxi Song Rui Fu Kefei Dou Shuai Liu Qianqian Liu Xiaohui Bian Weida Liu Chengang Zhu Jingjing Gao Sheng Yuan Xinming Cui Sijia Qin Yumeng Li Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study BMJ Open |
| title | Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study |
| title_full | Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study |
| title_fullStr | Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study |
| title_full_unstemmed | Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study |
| title_short | Clinical implication of NT-proBNP to predict mortality in patients with acute type A aortic dissection: a retrospective cohort study |
| title_sort | clinical implication of nt probnp to predict mortality in patients with acute type a aortic dissection a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/15/1/e093757.full |
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