B-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure
Abstract Fluid overload is a common complication in patients with cirrhosis. B-type natriuretic peptide (BNP) is a marker of increased blood volume, commonly used in heart failure, that has been shown to be elevated in patients with liver disease. This study examined if BNP levels can be used to det...
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Nature Portfolio
2021
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oai:doaj.org-article:fd0760b38b47429683a3d984c7aec3302021-12-02T15:23:47ZB-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure10.1038/s41598-020-78946-32045-2322https://doaj.org/article/fd0760b38b47429683a3d984c7aec3302021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-78946-3https://doaj.org/toc/2045-2322Abstract Fluid overload is a common complication in patients with cirrhosis. B-type natriuretic peptide (BNP) is a marker of increased blood volume, commonly used in heart failure, that has been shown to be elevated in patients with liver disease. This study examined if BNP levels can be used to determine prognosis and predict worsening of ascites in patients with cirrhosis without concomitant heart disease. A retrospective study was performed at a large urban hospital in Chicago, Illinois and included 430 patients with cirrhosis who had BNP levels ordered during their hospital stay. Patients with clinical heart failure, arrhythmias or pulmonary hypertension were excluded. The primary outcome was 90-day mortality and the secondary outcome was a requirement for therapeutic paracentesis in the 90 days following BNP results. 53 patients (12%) had BNP levels ≥ 300 pg/mL. They had significantly increased serum levels of creatinine, bilirubin, and International Normalized Ratio (INR) when compared to those with BNP < 300 pg/mL. Patients with higher BNP had significantly higher mortality rates (HR 3.49; p = 0.037) and were more likely to require therapeutic paracentesis (HR 2.26; p = 0.02) in the next 90 days. A BNP ≥ 300 pg/mL had specificity of 88.2% in predicting 90-day mortality. BNP may serve as a practical and reliable marker of underlying disease severity in patients with cirrhosis, with potential to be included in prognostication tools for assessment of end-stage liver disease.Tiago AraujoIshaan VohraPedro PalaciosVatsala KatiyarEstefania FloresTejinder RandhawaYuchen WangYazan Abu-OmarVijaya MukthinuthalapatiHemant MutnejaSanjay A. PatelBashar AttarNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021) |
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Medicine R Science Q Tiago Araujo Ishaan Vohra Pedro Palacios Vatsala Katiyar Estefania Flores Tejinder Randhawa Yuchen Wang Yazan Abu-Omar Vijaya Mukthinuthalapati Hemant Mutneja Sanjay A. Patel Bashar Attar B-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure |
| description |
Abstract Fluid overload is a common complication in patients with cirrhosis. B-type natriuretic peptide (BNP) is a marker of increased blood volume, commonly used in heart failure, that has been shown to be elevated in patients with liver disease. This study examined if BNP levels can be used to determine prognosis and predict worsening of ascites in patients with cirrhosis without concomitant heart disease. A retrospective study was performed at a large urban hospital in Chicago, Illinois and included 430 patients with cirrhosis who had BNP levels ordered during their hospital stay. Patients with clinical heart failure, arrhythmias or pulmonary hypertension were excluded. The primary outcome was 90-day mortality and the secondary outcome was a requirement for therapeutic paracentesis in the 90 days following BNP results. 53 patients (12%) had BNP levels ≥ 300 pg/mL. They had significantly increased serum levels of creatinine, bilirubin, and International Normalized Ratio (INR) when compared to those with BNP < 300 pg/mL. Patients with higher BNP had significantly higher mortality rates (HR 3.49; p = 0.037) and were more likely to require therapeutic paracentesis (HR 2.26; p = 0.02) in the next 90 days. A BNP ≥ 300 pg/mL had specificity of 88.2% in predicting 90-day mortality. BNP may serve as a practical and reliable marker of underlying disease severity in patients with cirrhosis, with potential to be included in prognostication tools for assessment of end-stage liver disease. |
| format |
article |
| author |
Tiago Araujo Ishaan Vohra Pedro Palacios Vatsala Katiyar Estefania Flores Tejinder Randhawa Yuchen Wang Yazan Abu-Omar Vijaya Mukthinuthalapati Hemant Mutneja Sanjay A. Patel Bashar Attar |
| author_facet |
Tiago Araujo Ishaan Vohra Pedro Palacios Vatsala Katiyar Estefania Flores Tejinder Randhawa Yuchen Wang Yazan Abu-Omar Vijaya Mukthinuthalapati Hemant Mutneja Sanjay A. Patel Bashar Attar |
| author_sort |
Tiago Araujo |
| title |
B-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure |
| title_short |
B-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure |
| title_full |
B-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure |
| title_fullStr |
B-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure |
| title_full_unstemmed |
B-type natriuretic peptide (BNP) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure |
| title_sort |
b-type natriuretic peptide (bnp) predicts 90-day mortality and need for paracentesis in cirrhotic patients without systolic heart failure |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/fd0760b38b47429683a3d984c7aec330 |
| work_keys_str_mv |
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