住院患者的BNP水平Dry.PPT

This graph shows the take home points of the predischarge BNP study. At BNP levels over 700 there is a significant increase in risk of death or readmission. Levels less than 350 confer a significantly lower risk. The hazard ratios are on the right, and the results are statistically significant. These data are from the validation and derivation (whole population). CLINDEVOR360, Inc. Capabilities * CLINDEVOR360, Inc. Capabilities * Italian Red in prep- Disomma, Maisel et al 出院后30天的BNP 水平比出院前BNP水平更具预后价值 Discharge BNP AUC .6 30 day BNP AUC .7 Italian Red in prep- Disomma, Maisel et al BNP家庭检测-未来 肌钙蛋白和 ADHERE 项目中的死亡率 Peacock, NEJM May 15, 08 肌钙蛋白 I和T的院内死亡率四分位数 Peacock, NEJM May 15, 08 From April 2003 through December 2004 there were 48,629 eligible acute HF hospitalization episodes in the ADHERE Registry with documented BNP level and LVEF (LVEF 40%, N = 18,164; LVEF 40%, N = 19,544). BNP levels were 100 in only 3.3% of the total cohort hospitalized with a primary discharge diagnosis of HF. Can we use BNP as a surrogate? One study…. * The purpose of this study was to demonstrate that variations in BNP levels during hormone-guided treatment and measured body hydration status by bioelectrical impedance analysis enable the timing of the patient’s discharge to be optimized and can predict the occurrence of cardiovascular events in the subsequent 6 months. * * 应用BNP水平对入院患者进行监控和风险分层 Alan Maisel MD, FACC, ACP Professor of Medicine, University of California, San Diego Director Coronary Care Unit And Heart Failure Program San Diego Veterans Hospital 在美国，因心衰入院人数=每年一百万。总费用=560亿美元 住院治疗花费中，70-75%直接用于患者护理 心衰住院治疗后再入院=6个月内达45% 心衰的治疗负担 ADHF中的BNP水平和院内死亡率 BNP水平的分布 (pg/mL) 在初期评估中，77,467例患者中有 48,629 例 (63%)作了BNP评估. 在ADHERE项目中仅 3.3%的患者 初始 BNP水平 100 pg/mL Fonarow et al, JACC 2007 in press 入院BNP水平降低院内死亡率风险 vs.保护心衰患者的心脏收缩功能 在初期评估中，77,467例患者中有 48,629 例 (63%)作了BNP评估 19,544 例左室射血分数 0.40 和 18,164例左室射血分数 0.40 Q2 2003 to Q4 2004 P0.0001 P0.0001 LVEF 0.40 LVEF 0.40 ADHERE项目中BNP水平四分位