title: Predictive cutoff point of admission N-terminal pro-B-type natriuretic peptide testing in the ED for prognosis of patients with acute heart failure.
abstract: OBJECTIVE
  The main objective of this study was to determine a cutoff level of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) that could successfully predict the short- and long-term prognosis of patients with acute heart failure at the time of admission to the emergency department. The results of our study are presented in context with previously published literature. We believe that the present study will be useful and salutary for the progress of literature.
  
  
  METHODS
  N-terminal pro-B-type natriuretic peptide plasma levels were obtained from 100 patients with shortness of breath and left ventricular dysfunction upon admission to the emergency department. All patients underwent follow-up evaluations 30 days and 1 year after admission. The end point was defined as all-cause mortality.
  
  
  RESULTS
  The mean age of the patients in this study was 70.8 ± 11.6 years, and 51% were female. All-cause mortality at the 30-day and 1-year follow-up evaluations was 21.2% and 53.5%, respectively. We determined that the optimal NT-proBNP cutoff point for predicting 30-day mortality at the time of admission was 9152.4 pg/mL, with a 71.4% sensitivity and an 81.3% specificity (95% confidence interval, area under the curve: 0.726; P = .002). The optimal NT-proBNP cutoff point for predicting 1-year mortality at the time of admission was 3630.5 pg/mL, with an 83.0% sensitivity and a 52.2% specificity (95% confidence interval, area under the curve: 0.644; P = .014).
  
  
  CONCLUSIONS
  Elevated NT-proBNP levels at the time of admission are a strong and independent predictor of all-cause mortality in patients with acute heart failure at 30 days and 1 year after admission. Furthermore, the optimal cutoff level of NT-proBNP used to predict 30-day and 1-year mortality had high sensitivity.
authors.affiliation: Department of Emergency Medicine, Bitlis State Hospital, Bitlis, Turkey. dryalcingolcuk@gmail.com
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Golcuk
authors.forename: Burcu
authors.initials: B
authors.lastname: Golcuk
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Velibey
authors.forename: Deniz
authors.initials: D
authors.lastname: Oray
authors.forename: Ozge Duman
authors.initials: OD
authors.lastname: Atilla
authors.forename: Ayfer
authors.initials: A
authors.lastname: Colak
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Kurtulmus
authors.forename: Aydin
authors.initials: A
authors.lastname: Yildirim
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain