n-probnp在心衰诊断、预后、治疗的管理陈鲁原PPT.ppt

Total Mortality PRIMA-study Survival (%) Time (days) P=0.208 NT-proBNP guided Clinical guided 46/174 26.5% 57/171 33.3% Secondary analysis PRIMA-study Cardiovascular mortality ns Combined endpoint CV mortality / readmissions ns HF related readmissions ns Creatinine above / below the median (123 mcm/L) ns Age above / below 73 years ns Discharge NT-proBNP above / below 2950 pg/ml ns On NT-proBNP target analysis: Primary endpoint PRIMA-study On NT-proBNP Target Clinical Guided group 院外平均存活天数 (median + IQR) 721 (578-730) p.001 664 (435-726) 101 of 174 patients in NT-proBNP guided group (58%) maintained their target in more than 75% of visits 按出院后维持NT-proBNP靶标作对照 p.001 On NT-proBNP target: Mortality (%) PRIMA-study On NT-proBNP Target Clinical Guided group p0.001 11/101 10.9% 57/171 33.3% 101 of 174 patients in NT-proBNP guided group (58%) maintained their target in more than 75% of visits 按出院后维持NT-proBNP靶标作对照 Conclusions Management of heart failure guided by an individually  defined optimal NT-proBNP level does not appear  favorable in the overall population However, maintaining this individual optimal NT-proBNP level portends significantly better outcome The PRIMA-study allows to identify patients where it is  feasible to maintain the optimal NT-proBNP level and who  may benefit from treatment guided by their own optimal  NT-proBNP PRIMA-study 血浆中利钠肽:在HF诊断和慢性HF患者管理 （结束语） 在HF诊断和慢性HF患者管理中，血浆中利钠肽浓度是有用的生物标志物。利钠肽可作为HF诊断、分期、住院/出院的依据 利钠肽也可能有助于在出院之前评估预后，并且监测HF治疗的有效性 然而它们用在调整药物治疗的证据并不明确，需要扩大样本量研究哪些人群可以明显改善预后 或许NT-proBNP联合肾功能、贫血、心肌损伤或炎症指标的检测，对改善预后更有帮助？ Thank you There were no significant differences between the 2 treatment groups by N-terminal BNP level (P=.30). TIME-CHF: N-terminal BNP level JAMA. 2009;301(4):383-392 25分钟 NT-proBNP in the dagnoses of acute heart failure Judgemen of prognosis 充血性心力衰竭: 在临床上是否易于诊断? Independent predictors of acute heart failure in dyspneic