Serum Blood Urea Nitrogen and Plasma Brain Natriuretic Peptide and Low Diastolic Blood Pressure Predict Cardiovascular Morbidity and Mortality Following Discharge in Acute Decompensated Heart Failure Patients

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Author(s)

    • CHEN Chun-Yen
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • YOSHIDA Akemi
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • ASAKURA Masanori
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • HASEGAWA Takuya
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • TAKAHAMA Hiroyuki
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • AMAKI Makoto
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • FUNADA Akira
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • ASANUMA Hiroshi
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • YOKOYAMA Hiroyuki
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • KIM Jiyoong
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • KANZAKI Hideaki
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
    • KITAKAZE Masafumi
    • Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

Abstract

<b><i>Background:</i></b> Patients with heart failure (HF) have a high risk of cardiovascular (CV) death and re-hospitalization. The purpose of the present study was therefore to investigate predictors of CV death and re-hospitalization for acute decompensated HF (ADHF). <b><i>Methods and Results:</i></b> A total of 225 patients aged 67.2±15.2 years, including 134 men (59.6%), who were hospitalized for ADHF between 2008 and 2009, were followed up. After discharge, the relationship between clinical parameters and CV events (ie, CV death or re-hospitalization for HF) was examined. Follow-up was continued until 30 April 2011. The most important predictors of re-hospitalization were serum blood urea nitrogen (BUN; adjusted hazard ratio [HR], 1.02; 95% confidence interval [CI]: 1.00–1.03, P=0.01), plasma brain natriuretic peptide (BNP; adjusted HR, 1.85; 95% CI: 1.12–3.04, P=0.02), and diastolic blood pressure (DBP; adjusted HR, 0.97; 95% CI: 0.94–1.00, P=0.049). The only predictor of CV mortality was a high BUN (adjusted HR, 1.05; 95% CI: 1.01–1.09, P=0.01). <b><i>Conclusions:</i></b> High serum BUN (≥22.5mg/dl), high plasma BNP (≥250pg/ml), and low DBP (<60mmHg) predict CV events in patients hospitalized for ADHF. These factors may identify high-risk patients for CV events and provide therapeutic targets for managing HF.  (<i>Circ J</i> 2012; <b>76:</b> 2372–2379)<br>

Journal

  • Circulation Journal

    Circulation Journal 76(10), 2372-2379, 2012-09-25

    The Japanese Circulation Society

References:  28

Cited by:  2

Codes

  • NII Article ID (NAID)
    10030874757
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    13469843
  • Data Source
    CJP  CJPref  J-STAGE 
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