Dataset Information

Ejection fraction, B-type natriuretic peptide and risk of stroke and acute myocardial infarction among patients with heart failure.

ABSTRACT:

Background

Real-world data on the clinical outcomes of heart failure (HF) across the spectrum of ejection fraction (EF) and the prognostic value of B-type natriuretic peptide (BNP) have not been well examined.

Hypothesis

The real-world association between the clinical outcomes of HF and EF or BNP levels may differ across different EF or BNP values.

Methods

The Optum Integrated Claims-Clinical data (07/2009-09/2016) was used to identify adult patients with ?1 HF diagnosis during hospitalization or emergency room visit. Three EF cohorts were formed: reduced (rEF; EF < 40%), mid-range (mrEF; EF 40%-49%), and preserved EF (pEF; EF ? 50%). Stratifications by BNP levels were performed using median BNP as cutoff between high vs low BNP (H-BNP vs L-BNP).

Results

In total, 7005 HF patients with EF measurements (2456 patients with both HF and BNP measurements) were identified. rEF patients had higher risk of stroke (hazard ratio [HR] = 1.57, P = 0.010) and acute myocardial infarction (AMI) (HR = 2.42, P < 0.001) compared to pEF patients. H-BNP was associated with a significantly higher risk of mortality (P < 0.001). rEF patients with H-BNP had a significantly higher risk of stroke than those with L-BNP.

Conclusions

Patients with rEF had a significantly higher rate of stroke and AMI vs pEF patients, as did patients with H-BNP vs L-BNP. The present study is the first to show the real-world association of EF and BNP (alone and in combination) with clinical outcomes, further supporting the recommendation to use these markers in clinical practice. These results may help to guide future recommendations and improve the clinical management of HF.

SUBMITTER: Greenberg B

PROVIDER: S-EPMC6712323 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Ejection fraction, B-type natriuretic peptide and risk of stroke and acute myocardial infarction among patients with heart failure.

Greenberg Barry B Peterson Eric D ED Berger Jeffrey S JS Laliberté François F Zhao Qi Q Germain Guillaume G Lejeune Dominique D Wu Jennifer W JW Lefebvre Patrick P Fonarow Gregg C GC

Clinical cardiology 20190107 2

<h4>Background</h4>Real-world data on the clinical outcomes of heart failure (HF) across the spectrum of ejection fraction (EF) and the prognostic value of B-type natriuretic peptide (BNP) have not been well examined.<h4>Hypothesis</h4>The real-world association between the clinical outcomes of HF and EF or BNP levels may differ across different EF or BNP values.<h4>Methods</h4>The Optum Integrated Claims-Clinical data (07/2009-09/2016) was used to identify adult patients with ≥1 HF diagnosis du ...[more]

PMID: 30578576

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Dataset Information

Ejection fraction, B-type natriuretic peptide and risk of stroke and acute myocardial infarction among patients with heart failure.

Background

Hypothesis

Methods

Results

Conclusions

Publications

Ejection fraction, B-type natriuretic peptide and risk of stroke and acute myocardial infarction among patients with heart failure.

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