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N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort
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| Zeitschriftentitel: | Journal of the American Heart Association |
|---|---|
| Personen und Körperschaften: | , , , , , , , , , , |
| In: | Journal of the American Heart Association, 10, 2021, 24 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Ovid Technologies (Wolters Kluwer Health)
|
| Schlagwörter: |
| author_facet |
O’Donnell, Christian Ashland, Melanie D. Vasti, Elena C. Lu, Ying Chang, Andrew Y. Wang, Paul Daniels, Lori B. de Lemos, James A. Morrow, David A. Rodriguez, Fatima O’Brien, Connor G. O’Donnell, Christian Ashland, Melanie D. Vasti, Elena C. Lu, Ying Chang, Andrew Y. Wang, Paul Daniels, Lori B. de Lemos, James A. Morrow, David A. Rodriguez, Fatima O’Brien, Connor G. |
|---|---|
| author |
O’Donnell, Christian Ashland, Melanie D. Vasti, Elena C. Lu, Ying Chang, Andrew Y. Wang, Paul Daniels, Lori B. de Lemos, James A. Morrow, David A. Rodriguez, Fatima O’Brien, Connor G. |
| spellingShingle |
O’Donnell, Christian Ashland, Melanie D. Vasti, Elena C. Lu, Ying Chang, Andrew Y. Wang, Paul Daniels, Lori B. de Lemos, James A. Morrow, David A. Rodriguez, Fatima O’Brien, Connor G. Journal of the American Heart Association N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort Cardiology and Cardiovascular Medicine |
| author_sort |
o’donnell, christian |
| spelling |
O’Donnell, Christian Ashland, Melanie D. Vasti, Elena C. Lu, Ying Chang, Andrew Y. Wang, Paul Daniels, Lori B. de Lemos, James A. Morrow, David A. Rodriguez, Fatima O’Brien, Connor G. 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.121.022913 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en">Currently, there is limited research on the prognostic value of NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) as a biomarker in COVID‐19. We proposed the a priori hypothesis that an elevated NT‐proBNP concentration at admission is associated with increased in‐hospital mortality.</jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> In this prospective, observational cohort study of the American Heart Association’s COVID‐19 Cardiovascular Disease Registry, 4675 patients hospitalized with COVID‐19 were divided into normal and elevated NT‐proBNP cohorts by standard age‐adjusted heart failure thresholds, as well as separated by quintiles. Patients with elevated NT‐proBNP (n=1344; 28.7%) were older, with more cardiovascular risk factors, and had a significantly higher rate of in‐hospital mortality (37% versus 16%; <jats:italic>P</jats:italic> <0.001) and shorter median time to death (7 versus 9 days; <jats:italic>P</jats:italic> <0.001) than those with normal values. Analysis by quintile of NT‐proBNP revealed a steep graded relationship with mortality (7.1%–40.2%; <jats:italic>P</jats:italic> <0.001). NT‐proBNP was also associated with major adverse cardiac events, intensive care unit admission, intubation, shock, and cardiac arrest ( <jats:italic>P</jats:italic> <0.001 for each). In subgroup analyses, NT‐proBNP, but not prior heart failure, was associated with increased risk of in‐hospital mortality. Adjusting for cardiovascular risk factors with presenting vital signs, an elevated NT‐proBNP was associated with 2‐fold higher adjusted odds of death (adjusted odds ratio [OR], 2.23; 95% CI, 1.80–2.76), and the log‐transformed NT‐proBNP with other biomarkers projected a 21% increased risk of death for each 2‐fold increase (adjusted OR, 1.21; 95% CI, 1.08–1.34). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en">Elevated NT‐proBNP levels on admission for COVID‐19 are associated with an increased risk of in‐hospital mortality and other complications in patients with and without heart failure.</jats:p> </jats:sec> N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort Journal of the American Heart Association |
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10.1161/jaha.121.022913 |
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Ovid Technologies (Wolters Kluwer Health), 2021 |
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| title |
N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_unstemmed |
N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_full |
N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_fullStr |
N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_full_unstemmed |
N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_short |
N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_sort |
n‐terminal pro‐b‐type natriuretic peptide as a biomarker for the severity and outcomes with covid‐19 in a nationwide hospitalized cohort |
| topic |
Cardiology and Cardiovascular Medicine |
| url |
http://dx.doi.org/10.1161/jaha.121.022913 |
| publishDate |
2021 |
| physical |
|
| description |
<jats:sec xml:lang="en">
<jats:title>Background</jats:title>
<jats:p xml:lang="en">Currently, there is limited research on the prognostic value of NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) as a biomarker in COVID‐19. We proposed the a priori hypothesis that an elevated NT‐proBNP concentration at admission is associated with increased in‐hospital mortality.</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Methods and Results</jats:title>
<jats:p xml:lang="en">
In this prospective, observational cohort study of the American Heart Association’s COVID‐19 Cardiovascular Disease Registry, 4675 patients hospitalized with COVID‐19 were divided into normal and elevated NT‐proBNP cohorts by standard age‐adjusted heart failure thresholds, as well as separated by quintiles. Patients with elevated NT‐proBNP (n=1344; 28.7%) were older, with more cardiovascular risk factors, and had a significantly higher rate of in‐hospital mortality (37% versus 16%;
<jats:italic>P</jats:italic>
<0.001) and shorter median time to death (7 versus 9 days;
<jats:italic>P</jats:italic>
<0.001) than those with normal values. Analysis by quintile of NT‐proBNP revealed a steep graded relationship with mortality (7.1%–40.2%;
<jats:italic>P</jats:italic>
<0.001). NT‐proBNP was also associated with major adverse cardiac events, intensive care unit admission, intubation, shock, and cardiac arrest (
<jats:italic>P</jats:italic>
<0.001 for each). In subgroup analyses, NT‐proBNP, but not prior heart failure, was associated with increased risk of in‐hospital mortality. Adjusting for cardiovascular risk factors with presenting vital signs, an elevated NT‐proBNP was associated with 2‐fold higher adjusted odds of death (adjusted odds ratio [OR], 2.23; 95% CI, 1.80–2.76), and the log‐transformed NT‐proBNP with other biomarkers projected a 21% increased risk of death for each 2‐fold increase (adjusted OR, 1.21; 95% CI, 1.08–1.34).
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Conclusions</jats:title>
<jats:p xml:lang="en">Elevated NT‐proBNP levels on admission for COVID‐19 are associated with an increased risk of in‐hospital mortality and other complications in patients with and without heart failure.</jats:p>
</jats:sec> |
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| author | O’Donnell, Christian, Ashland, Melanie D., Vasti, Elena C., Lu, Ying, Chang, Andrew Y., Wang, Paul, Daniels, Lori B., de Lemos, James A., Morrow, David A., Rodriguez, Fatima, O’Brien, Connor G. |
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| description | <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en">Currently, there is limited research on the prognostic value of NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) as a biomarker in COVID‐19. We proposed the a priori hypothesis that an elevated NT‐proBNP concentration at admission is associated with increased in‐hospital mortality.</jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> In this prospective, observational cohort study of the American Heart Association’s COVID‐19 Cardiovascular Disease Registry, 4675 patients hospitalized with COVID‐19 were divided into normal and elevated NT‐proBNP cohorts by standard age‐adjusted heart failure thresholds, as well as separated by quintiles. Patients with elevated NT‐proBNP (n=1344; 28.7%) were older, with more cardiovascular risk factors, and had a significantly higher rate of in‐hospital mortality (37% versus 16%; <jats:italic>P</jats:italic> <0.001) and shorter median time to death (7 versus 9 days; <jats:italic>P</jats:italic> <0.001) than those with normal values. Analysis by quintile of NT‐proBNP revealed a steep graded relationship with mortality (7.1%–40.2%; <jats:italic>P</jats:italic> <0.001). NT‐proBNP was also associated with major adverse cardiac events, intensive care unit admission, intubation, shock, and cardiac arrest ( <jats:italic>P</jats:italic> <0.001 for each). In subgroup analyses, NT‐proBNP, but not prior heart failure, was associated with increased risk of in‐hospital mortality. Adjusting for cardiovascular risk factors with presenting vital signs, an elevated NT‐proBNP was associated with 2‐fold higher adjusted odds of death (adjusted odds ratio [OR], 2.23; 95% CI, 1.80–2.76), and the log‐transformed NT‐proBNP with other biomarkers projected a 21% increased risk of death for each 2‐fold increase (adjusted OR, 1.21; 95% CI, 1.08–1.34). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en">Elevated NT‐proBNP levels on admission for COVID‐19 are associated with an increased risk of in‐hospital mortality and other complications in patients with and without heart failure.</jats:p> </jats:sec> |
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| spelling | O’Donnell, Christian Ashland, Melanie D. Vasti, Elena C. Lu, Ying Chang, Andrew Y. Wang, Paul Daniels, Lori B. de Lemos, James A. Morrow, David A. Rodriguez, Fatima O’Brien, Connor G. 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.121.022913 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en">Currently, there is limited research on the prognostic value of NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) as a biomarker in COVID‐19. We proposed the a priori hypothesis that an elevated NT‐proBNP concentration at admission is associated with increased in‐hospital mortality.</jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> In this prospective, observational cohort study of the American Heart Association’s COVID‐19 Cardiovascular Disease Registry, 4675 patients hospitalized with COVID‐19 were divided into normal and elevated NT‐proBNP cohorts by standard age‐adjusted heart failure thresholds, as well as separated by quintiles. Patients with elevated NT‐proBNP (n=1344; 28.7%) were older, with more cardiovascular risk factors, and had a significantly higher rate of in‐hospital mortality (37% versus 16%; <jats:italic>P</jats:italic> <0.001) and shorter median time to death (7 versus 9 days; <jats:italic>P</jats:italic> <0.001) than those with normal values. Analysis by quintile of NT‐proBNP revealed a steep graded relationship with mortality (7.1%–40.2%; <jats:italic>P</jats:italic> <0.001). NT‐proBNP was also associated with major adverse cardiac events, intensive care unit admission, intubation, shock, and cardiac arrest ( <jats:italic>P</jats:italic> <0.001 for each). In subgroup analyses, NT‐proBNP, but not prior heart failure, was associated with increased risk of in‐hospital mortality. Adjusting for cardiovascular risk factors with presenting vital signs, an elevated NT‐proBNP was associated with 2‐fold higher adjusted odds of death (adjusted odds ratio [OR], 2.23; 95% CI, 1.80–2.76), and the log‐transformed NT‐proBNP with other biomarkers projected a 21% increased risk of death for each 2‐fold increase (adjusted OR, 1.21; 95% CI, 1.08–1.34). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en">Elevated NT‐proBNP levels on admission for COVID‐19 are associated with an increased risk of in‐hospital mortality and other complications in patients with and without heart failure.</jats:p> </jats:sec> N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort Journal of the American Heart Association |
| spellingShingle | O’Donnell, Christian, Ashland, Melanie D., Vasti, Elena C., Lu, Ying, Chang, Andrew Y., Wang, Paul, Daniels, Lori B., de Lemos, James A., Morrow, David A., Rodriguez, Fatima, O’Brien, Connor G., Journal of the American Heart Association, N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort, Cardiology and Cardiovascular Medicine |
| title | N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_full | N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_fullStr | N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_full_unstemmed | N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_short | N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| title_sort | n‐terminal pro‐b‐type natriuretic peptide as a biomarker for the severity and outcomes with covid‐19 in a nationwide hospitalized cohort |
| title_unstemmed | N‐Terminal Pro‐B‐Type Natriuretic Peptide as a Biomarker for the Severity and Outcomes With COVID‐19 in a Nationwide Hospitalized Cohort |
| topic | Cardiology and Cardiovascular Medicine |
| url | http://dx.doi.org/10.1161/jaha.121.022913 |