Predicting cardiogenic pulmonary edema in heart failure patients by using an N-terminal pro-b-type natriuretic peptide (NT-pro BNP) -based score

Clin Chim Acta. 2018 May:480:26-33. doi: 10.1016/j.cca.2018.01.042. Epub 2018 Feb 20.

Abstract

Background: Cardiogenic pulmonary edema (CPE) is a life-threatening emergency necessitating aggressive management. We conducted this study to test the hypothesis that a combination of N-terminal pro-b-type natriuretic peptide (NT-pro-BNP) and some relevant clinical factors may provide better predictability for CPE in heart failure (HF) patients.

Methods: This retrospective study enrolled adult HF patients hospitalized during January 2011 to December 2013. After determining the independent predictors for the occurrence of CPE, a novel NT-pro BNP-based diagnostic score for predicting CPE was established.

Results: A total of 269 patients (mean age, 74.5 ± 13.6 years; female, 53.9%) were enrolled, and categorized into CPE group (n = 80, 29.7%) and non-CPE group (n = 189, 70.3%). Several factors such as "Serum NT-pro-BNP level > 6980 mg/dl," "systemic blood pressure > 170 mm Hg," "heart rate > 120 bpm," "with rales in breathing sound," "with jugular vein engorgement," "with NYHA Fc III/IV," "with chronic lung disease" and "with angiotensin converting enzyme inhibitors/angiotensin receptor blocker" were found to be associated with the existence of CPE. A novel NT-pro BNP based scoring system containing these risk factors was proposed and proven excellent in predicting CPE.

Conclusions: The NT-pro-BNP scoring system could predict CPE in HF patients.

Keywords: Cardiogenic pulmonary edema; Heart failure; NT-pro-BNP; Scoring system.

MeSH terms

  • Aged
  • Cohort Studies
  • Female
  • Heart Failure / blood*
  • Humans
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Pulmonary Edema / blood*
  • Pulmonary Edema / complications
  • Retrospective Studies
  • Taiwan

Substances

  • Natriuretic Peptide, Brain