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ORIGINAL ARTICLE
Year : 2019  |  Volume : 7  |  Issue : 2  |  Page : 49-54

Role of B-type natriuretic peptide level in predicting future cardiac events in patients presenting with dyspnea (a hospital-based study)


Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

Correspondence Address:
Dr. Lalit Prashant Meena
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/heartindia.heartindia_17_19

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Introduction: Acute dyspnea is one of the most common reasons for admission to emergency rooms. Differentiation of heart failure (HF) from other causes of shortness of breath is often difficult but compulsory. Natriuretic peptides are present in higher concentration in patients with HF and have a potential diagnostic role. The decline in B type natriuretic peptide (BNP) levels subsequent to the treatment of acute HF could predict the future risk of HF and/or cardiac event. Materials and Methods: This was an in-hospital longitudinal study conducted on adult patients presenting with acute dyspnea to the Department of General Medicine in our institution from January 1, 2016, to December 31, 2016. Eligible patients were followed up over a period of the next 6 months from their day of the first visit. Patients presenting with acute dyspnea were selected. Patients were evaluated using predetermined pro forma including history, physical examination, blood investigations, electrocardiography, chest X-ray, BNP analysis, and two-dimensional echo. BNP levels of the patients with BNP >500 pg/ml at the time of admission were again measured at the time of discharge, and these patients were followed up for 6 months for any endpoint. Results: This study of 100 participants gives insight about common etiologies among the patients presenting with acute dyspnea in which HF is a competing diagnosis. In the study, a BNP cutoff of 413 pg/ml determines cardiogenic dyspnea. Out of 60 patients with BNP >500 pg/ml at admission, 22 patients had at least 1 endpoint by the end of 6 months. Cutoff for determination of an endpoint for BNP at admission and BNP at discharge was 1298 and 367.5 pg/ml, respectively. Conclusion: The study showed that BNP at admission and BNP at discharge determines prognosis in patients presenting with dyspnea. The study shows BNP as a better predictor of prognosis than ejection fraction or past history of any cardiac event.


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