Natriuretic peptides in addition to Zwolle score to enhance safe and early discharge after acute myocardial infarction: A prospective observational cohort study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F16%3A00065337" target="_blank" >RIV/65269705:_____/16:00065337 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/16:00090477

Výsledek na webu

<a href="http://10.1016/j.ijcard.2016.04.148" target="_blank" >http://10.1016/j.ijcard.2016.04.148</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ijcard.2016.04.148" target="_blank" >10.1016/j.ijcard.2016.04.148</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Natriuretic peptides in addition to Zwolle score to enhance safe and early discharge after acute myocardial infarction: A prospective observational cohort study

Popis výsledku v původním jazyce

Background: The Zwolle score is recommended to identify low-risk patients eligible for early hospital discharge after ST-elevation myocardial infarction (STEMI), but since only one third of STEMI has low Zwolle score, hospital discharge is frequently delayed. B-type natriuretic peptide (BNP) also provides prognostic information after STEMI. The aim of the study was to test the hypothesis that patients with high Zwolle score associated with low BNP share similar outcomes than those with low Zwolle score. Methods and results: The study population consisted of 1032 consecutive STEMI patients in whom BNP was measured 24 h after chest pain onset. The area under the curve of Zwolle score and plasma BNP for 30-day mortality were 0.82 and 0.87, p = 0.39. A BNP threshold of 200 pg/ml had sensitivity of 100% and specificity of 34% for predicting 30-day mortality. Patients with high Zwolle score and BNP = 200 pg/ml (n = 183) had similar mortality and hospital stay to those with low Zwolle score (0% vs. 0.5% and 5 vs. 5 days, both p= 1.0). By contrast, patients with high Zwolle score and BNP > 200 pg/ml had the highest mortality (6.7%) and the longest hospital stay (6 days), both p < 0.01. Conclusion: STEMI patients with high Zwolle score but low BNP share similar outcomes with those with low Zwolle score and should be eligible for early discharge. Hence, using the rule of "low-Zwolle or low-BNP" might increase the number of STEMI patients that might be eligible for early discharge.

Název v anglickém jazyce

Natriuretic peptides in addition to Zwolle score to enhance safe and early discharge after acute myocardial infarction: A prospective observational cohort study

Popis výsledku anglicky

Background: The Zwolle score is recommended to identify low-risk patients eligible for early hospital discharge after ST-elevation myocardial infarction (STEMI), but since only one third of STEMI has low Zwolle score, hospital discharge is frequently delayed. B-type natriuretic peptide (BNP) also provides prognostic information after STEMI. The aim of the study was to test the hypothesis that patients with high Zwolle score associated with low BNP share similar outcomes than those with low Zwolle score. Methods and results: The study population consisted of 1032 consecutive STEMI patients in whom BNP was measured 24 h after chest pain onset. The area under the curve of Zwolle score and plasma BNP for 30-day mortality were 0.82 and 0.87, p = 0.39. A BNP threshold of 200 pg/ml had sensitivity of 100% and specificity of 34% for predicting 30-day mortality. Patients with high Zwolle score and BNP = 200 pg/ml (n = 183) had similar mortality and hospital stay to those with low Zwolle score (0% vs. 0.5% and 5 vs. 5 days, both p= 1.0). By contrast, patients with high Zwolle score and BNP > 200 pg/ml had the highest mortality (6.7%) and the longest hospital stay (6 days), both p < 0.01. Conclusion: STEMI patients with high Zwolle score but low BNP share similar outcomes with those with low Zwolle score and should be eligible for early discharge. Hence, using the rule of "low-Zwolle or low-BNP" might increase the number of STEMI patients that might be eligible for early discharge.

Druh

J_x - Nezařazeno - Článek v odborném periodiku (Jimp, Jsc a Jost)

CEP obor

FA - Kardiovaskulární nemoci včetně kardiochirurgie

OECD FORD obor

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Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2016

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

International Journal of Cardiology

ISSN

0167-5273

e-ISSN

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Svazek periodika

2016

Číslo periodika v rámci svazku

215

Stát vydavatele periodika

IE - Irsko

Počet stran výsledku

5

Strana od-do

527-531

Kód UT WoS článku

000376297100115

EID výsledku v databázi Scopus

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