title: B-type natriuretic peptide-guided therapy and length of hospital stay post left ventricular assist device implantation.
abstract: B-type natriuretic peptide (BNP)-guided therapy during the early postoperative period following left ventricular assist device (LVAD) implantation has not been well described in the literature. We conducted a retrospective cohort study consisting of consecutive patients who underwent LVAD implantation at our institution during May 2009 to March 2013. The study was limited to patients receiving HeartMate II (Thoratec) or HVAD (HeartWare) LVADs. Patients with acute myocardial infarction were excluded. We compared between patients with multiple postoperative BNP tests (BNP-guided therapy) and earlier period patients who typically had only a baseline BNP measurement (non-BNP-guided therapy). A total of 85 patients underwent LVAD implantation during the study period. Eight patients were excluded (five acute myocardial infarction, three without BNP measurements). The only differences in the baseline characteristics of BNP versus non-BNP-guided therapy included age and female gender. The postoperative length of hospital stay (LOS) in the BNP-guided therapy group was 5 days shorter when compared with the non-BNP-guided therapy group. In multivariate analysis, BNP-guided therapy remained a significant predictor of reduced LOS. The use of repeated BNP measurements during the early postoperative period was associated with a significantly lower LOS post LVAD implantation.
authors.affiliation: From the *Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, Indiana; †Department of Biostatistics, IU School of Medicine, Indianapolis, Indiana; ‡IU Health Cardiovascular Surgeons, Indianapolis, Indiana; and §Department of Medicine, IU School of Medicine, Indianapolis, Indiana.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Hellman
authors.forename: Adnan S
authors.initials: AS
authors.lastname: Malik
authors.forename: Hongbo
authors.initials: H
authors.lastname: Lin
authors.forename: Changyu
authors.initials: C
authors.lastname: Shen
authors.forename: I-Wen
authors.initials: IW
authors.lastname: Wang
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Wozniak
authors.forename: Zubair A
authors.initials: ZA
authors.lastname: Hashmi
authors.forename: Arslan
authors.initials: A
authors.lastname: Shaukat
authors.forename: Jeanette
authors.initials: J
authors.lastname: Pickrell
authors.forename: Marco A
authors.initials: MA
authors.lastname: Caccamo
authors.forename: Irmina
authors.initials: I
authors.lastname: Gradus-Pizlo
authors.forename: Azam
authors.initials: A
authors.lastname: Hadi
mesh_terms: D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain