Russian Heart Failure Journal 2008year Importance of measuring brain natriuretic peptide for prediction of fatal cardiovascular evens in patients with left ventricular systolic dysfunction of ischemic genesis


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2008/

Importance of measuring brain natriuretic peptide for prediction of fatal cardiovascular evens in patients with left ventricular systolic dysfunction of ischemic genesis

Volkova S. Yu., Shalaev S. V.

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Urgency. Increased levels of NT-proBNP in patients with CHF of ischemic genesis may serve as an early predictor of fatal complications. Aim. Evaluating the prognostic value of NT-proBNP plasma levels in of patients with CHF and left ventricular systolic dysfunction (LV SDF) of ischemic genesis and comparing the obtained data with other predictors of fatal cardiovascular events. Materials and methods. A group of 52 patients with LV SDF of ischemic genesis (LV EF <40 %) was observed for 2.5 years. In addition to evaluation of CHF severity and echoCG monitoring, plasma levels of NT-proBNP were measured. Results. Survival of patients was significantly reduced with plasma levels of NT‑proBNP within the 4th quartile (> 732 fmol/ml). Death rate was 25 % in the course of prospective observation. Patients with LV EF <35 % had twice as high risk for fatal outcomes as patients with LV EF >35 %. Relative risk of fatal cardiovascular event was significantly higher with LV ESD above 5.8 cm, refusal of revascularization surgery, and elevated plasma levels of NT-proBNP above the median value (495 fmol/ml). The major factors influencing the survival of patients with LV systolic dysfunction included LV ESD <5.8 cm and plasma levels of NT-proBNP <1000 fmol/ml. Therefore measuring the plasma level of NT proBNP allows estimation of long-term risk for fatal cardiovascular events in IHD patients with LV SDF.
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