Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels

Abstract As advanced heart failure (HF) with elevated NT-proBNP is characterized by an activated coagulation system, coronary events clinically noticed as sudden or HF death may be more common after treatment with first- compared to newer-generation DES. Our study evaluates (1) if patients with left...

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Autores principales:	Christian Roth, Clemens Gangl, Walter S. Speidl, Georg Goliasch, Matthias Schneider, Daniel Dalos, Rudolf Berger
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0c8ae0d5ccd840b382c9f9eb0f930b19
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spelling	oai:doaj.org-article:0c8ae0d5ccd840b382c9f9eb0f930b192021-12-02T14:16:42ZDeath is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels10.1038/s41598-021-81569-x2045-2322https://doaj.org/article/0c8ae0d5ccd840b382c9f9eb0f930b192021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81569-xhttps://doaj.org/toc/2045-2322Abstract As advanced heart failure (HF) with elevated NT-proBNP is characterized by an activated coagulation system, coronary events clinically noticed as sudden or HF death may be more common after treatment with first- compared to newer-generation DES. Our study evaluates (1) if patients with left ventricular dysfunction (LVSD) who underwent percutaneous coronary intervention have a better survival with first- or newer-generation DES, and (2) if the survival benefit is predicted by NT-proBNP. Our observational study evaluated patients with LVSD who were registered in the coronary catheter laboratory database of the Medical University of Vienna. Multivariate Cox regression analyses tested an interaction in the risk of death between those with lower or elevated NT-proBNP levels and the stent-generation. The relative risk of newer- compared to first-generation DES as reference was calculated for patients with low and elevated NT-proBNP levels. In 340 patients (178 newer- and 162 first-generation DES) stent-generation and NT-proBNP were independent predictors of death. When the stent-generation*NTproBNP interaction was forced into a Cox regression model, this term independently predicted death. The relative risk of first- compared to newer-generation DES was similar in patients with lower NT-proBNP (HR 1.02, 95% CI 0.95–1.10, p = 0.560), but was higher in patients with elevated NT-proBNP (HR 1.06, 95% CI 1.01–1.10, p = 0.020). Death is associated to stent-generation. NT-proBNP is a predictor for the stent generation used: elevated levels demonstrated a higher mortality risk when using first- compared to newer-generation DES, while lower levels showed a similar risk when using either DES-generation.Christian RothClemens GanglWalter S. SpeidlGeorg GoliaschMatthias SchneiderDaniel DalosRudolf BergerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Christian Roth Clemens Gangl Walter S. Speidl Georg Goliasch Matthias Schneider Daniel Dalos Rudolf Berger Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels
description	Abstract As advanced heart failure (HF) with elevated NT-proBNP is characterized by an activated coagulation system, coronary events clinically noticed as sudden or HF death may be more common after treatment with first- compared to newer-generation DES. Our study evaluates (1) if patients with left ventricular dysfunction (LVSD) who underwent percutaneous coronary intervention have a better survival with first- or newer-generation DES, and (2) if the survival benefit is predicted by NT-proBNP. Our observational study evaluated patients with LVSD who were registered in the coronary catheter laboratory database of the Medical University of Vienna. Multivariate Cox regression analyses tested an interaction in the risk of death between those with lower or elevated NT-proBNP levels and the stent-generation. The relative risk of newer- compared to first-generation DES as reference was calculated for patients with low and elevated NT-proBNP levels. In 340 patients (178 newer- and 162 first-generation DES) stent-generation and NT-proBNP were independent predictors of death. When the stent-generation*NTproBNP interaction was forced into a Cox regression model, this term independently predicted death. The relative risk of first- compared to newer-generation DES was similar in patients with lower NT-proBNP (HR 1.02, 95% CI 0.95–1.10, p = 0.560), but was higher in patients with elevated NT-proBNP (HR 1.06, 95% CI 1.01–1.10, p = 0.020). Death is associated to stent-generation. NT-proBNP is a predictor for the stent generation used: elevated levels demonstrated a higher mortality risk when using first- compared to newer-generation DES, while lower levels showed a similar risk when using either DES-generation.
format	article
author	Christian Roth Clemens Gangl Walter S. Speidl Georg Goliasch Matthias Schneider Daniel Dalos Rudolf Berger
author_facet	Christian Roth Clemens Gangl Walter S. Speidl Georg Goliasch Matthias Schneider Daniel Dalos Rudolf Berger
author_sort	Christian Roth
title	Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels
title_short	Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels
title_full	Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels
title_fullStr	Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels
title_full_unstemmed	Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels
title_sort	death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0c8ae0d5ccd840b382c9f9eb0f930b19
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Death is associated to the type of drug-eluting stent in patients with left ventricular dysfunction and elevated natriuretic peptide levels

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