title: Post-discharge changes in NT-proBNP and quality of life after acute dyspnea hospitalization as predictors of one-year outcomes.
abstract: OBJECTIVE
  The association of serial NT-proBNP changes and poor quality of life (QOL) with progressive heart failure (HF) and clinical outcomes in emergency department dyspnea patients is poorly understood.
  
  
  RESULTS
  The predictive value of changes in NT-proBNP and QOL (Minnesota Living with Heart Failure scale) from baseline to 30-day follow-up was examined for all-cause 1-year mortality and HF hospitalization. Patients with an initially elevated NT-proBNP (≥300 ng/L) which persisted at 30-days (no ≥25% decrease) were at high risk of death or HF hospitalization (HR=6.36, 95%CI=3.04-13.28). Combined with sustained poor QOL, these subjects with persistently elevated NT-proBNP were at highest mortality risk or HF hospitalization (HR=8.75, 95%CI=3.62-21.16).
  
  
  CONCLUSIONS
  Dyspnea patients with elevated NT-proBNP concentrations and no improvement in either NT-proBNP or QOL at 30-days are at high risk of mortality and HF hospitalization. These data highlight the value of serial biomarker measurements combined with serial evaluations for QOL.
authors.affiliation: Virginia Commonwealth University Medical Center, Department of Medicine, Richmond, VA, USA.
authors.forename: Keyur B
authors.initials: KB
authors.lastname: Shah
authors.forename: Willem J
authors.initials: WJ
authors.lastname: Kop
authors.forename: Robert H
authors.initials: RH
authors.lastname: Christenson
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Diercks
authors.forename: Dick
authors.initials: D
authors.lastname: Kuo
authors.forename: Sue
authors.initials: S
authors.lastname: Henderson
authors.forename: Karen
authors.initials: K
authors.lastname: Hanson
authors.forename: Christopher R
authors.initials: CR
authors.lastname: deFilippi
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004417:Dyspnea / Q000097:blood* / Q000209:etiology / Q000628:therapy*; D006333:Heart Failure / Q000150:complications / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010351:Patient Discharge; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain