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The value of admission NT-proBNP in prognosis of patients hospitalized with COVID-19 and without history of heart failure.
Session:
Sessão Especial – Prémio Melhor Poster Electrónico
Speaker:
Rui Carlos Gregório Antunes Coelho
Congress:
CPC 2022
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.14 Cardiovascular Disease in Special Populations - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Rui Antunes Coelho; Jéni Quintal; Ana Rita Piteira; Joana Silvério Simões; Ricardo Pereira; David Noivo; Ana Reis; António Inácio; José Maria Farinha; Ana Fátima Esteves; António Pinheiro Cumena Candjondjo; Joana Silva Ferreira; Pedro Campos Amador; Rui Caria
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Background:</u> Coronavirus disease 2019 (COVID-19) has been associated with significant morbidity, including cardiovascular involvement. Elevation of N-terminal pro-B-type natriuretic peptide (NT-proBNP) was associated with worse prognosis in patients hospitalized with COVID-19. However, the relationship between admission NT-proBNP and prognosis of patients without previous history of heart failure is less established.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Purpose:</u> Evaluate if NTproBNP has a good discriminative power to predict in-hospital mortality in patients without previous history of heart failure hospitalized with COVID-19.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Methods:</u> We performed a retrospective analysis of 819 consecutive patients with COVID-19 admitted in our institution, in the third wave of the pandemic. We excluded patients without previous history of heart failure (n = 130) and patients in which it was not dosed NT-proBNP (n = 253). Receiver operator characteristics (ROC) curve and area under the curve (AUC) were obtained to determine the discriminative power of NT-proBNP as predictor of in-hospital mortality. Optimal cut-point value was obtained (Youden index) and patients were divided according to this value. Comparison between patients with and without NT-proBNP superior than the optimal cut-point was performed and in-hospital survival analysis was executed using a Cox Regression analysis (figure 1).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Results:</u> Optimal cut-point value of NT-proBNP for predicting in-hospital mortality in patients admitted with COVID-19 and without history of heart failure was 800,0 pg/mL (AUC 0,744, <em>p</em> < 0,001, 95% CI 0,691-0,798). The group of patients with NT-proBNP ≥ 800 pg/mL (n = 153; 31%) had a 5-fold increased risk of in-hospital mortality (HR 5,08; 95% CI 3,34-7,73; p <0,001). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Conclusions:</u> In the group of patients admitted in our institution with COVID-19 and without history of heart failure in the third wave of the pandemic, an admission NT-proBNP ≥ 800 pg/mL<sup> </sup>was an independent predictor of in-hospital mortality. A careful preventive strategy is needed for these patients.</span></span></p>
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