NT-proBNP: A Guide to Improve the Management of Patients with Heart Failure.
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ABSTRACT:
SUBMITTER: Latini R
PROVIDER: S-EPMC4975180 | biostudies-literature | 2013 Feb
REPOSITORIES: biostudies-literature
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NT-proBNP: A Guide to Improve the Management of Patients with Heart Failure.
Latini Roberto R Masson Serge S
EJIFCC 20130221 3
N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is a versatile biomarker, that has been extensively studied in large cohorts of individuals in the general population, in subjects at risk for developing left ventricular dysfunction and cardiovascular events, and in patients with chronic or acutely decompensated heart failure (HF). In this paper, the pros and cons of using natriuretic peptide testing to manage patients with HF are presented and discussed over 3 broad areas: (1) dysp ...[more]
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| S-EPMC3192281 | biostudies-literature
Project description:BackgroundPeriodontal disease (PD), resulting from inflammatory host response to dysbiotic subgingival microbiota, has been linked to cardiovascular disease; however, its relationship to heart failure (HF) and its subtypes (heart failure with reduced ejection fraction [HFrEF] and heart failure with preserved ejection fraction [HFpEF]) is unexplored.ObjectivesThe authors hypothesize that the presence of PD is associated with increased risk of incident HF, HFpEF, and HFrEF.MethodsA total of 6,707 participants (mean age 63 ± 6 years) of the ARIC (Atherosclerosis Risk In Communities) study with full-mouth periodontal examination at visit 4 (1996-1998) and longitudinal follow-up for any incident HF (visit 4 to 2018), or incident HFpEF and HFrEF (2005-2018) were included. Periodontal status was classified as follows: healthy, PD (as per Periodontal Profile Classification [PPC]), or edentulous. Multivariable-adjusted Cox proportional hazards models were used to calculate HRs and 95% CIs for the association between PPC levels and incident HF, HFpEF, or HFrEF. Additionally, biomarkers of inflammation (C-reactive protein [CRP]) and congestion (N-terminal brain natriuretic peptide [NT-proBNP]) were assessed.ResultsIn total, 1,178 incident HF cases occurred (350 HFpEF, 319 HFrEF, and 509 HF of unknown type) over a median of 13 years. Of these cases, 59% had PD, whereas 18% were edentulous. PD was associated with an increased risk for HFpEF (HR: 1.35 [95% CI: 0.98-1.86]) and significantly increased risk for HFrEF (HR: 1.69 [95% CI: 1.18-2.43]), as was edentulism: HFpEF (HR: 2.00 [95% CI: 1.37-2.93]), HFrEF (HR: 2.19 [95% CI: 1.43-3.36]). Edentulism was associated with unfavorable change in CRP and NT-proBNP, whereas PD was associated only with CRP.ConclusionsPeriodontal status was associated with incident HF, HFpEF, and HFrEF, as well as unfavorable changes in CRP and NT-proBNP.
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