Valvular heart diseasePrognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Active Infective Endocarditis
Section snippets
Patients
From May 2004 to May 2005, a total of 235 patients with suspected IE were evaluated at the Kosuyolu Heart and Research Hospital (Istanbul, Turkey), a tertiary center. Forty-eight patients met modified Duke’s criteria9 for definite IE. Three patients with pacemaker IE were excluded, and the remaining 45 patients were enrolled in this prospective study. In addition to plasma NT–pro-BNP and cTnI levels at admission, clinical, echocardiographic, and laboratory findings were recorded for each
Results
Thirty-four patients (76%) were male. Age range was 9 to 75 years (median 41). Underlying conditions related to IE were bicuspid aortic valve (11 patients, 24%), rheumatic heart disease (8 patients, 18%), degenerative heart disease (8 patients, 18%), prosthetic heart valves (8 patients, 18%), congenital heart disease (4 patients, 9%), mitral valve prolapse (1 patient, 2%), and obstructive hypertrophic cardiomyopathy (1 patient, 2%). Four subjects (9%) had no cardiac abnormality. None had a
Discussion
Our results suggest that NT–pro-BNP may be a valuable laboratory marker that allows risk stratification of patients with definite IE. Patients with IE had markedly increased NT–pro-BNP levels at admission (median 4,133 pg/ml). We also observed that patients who required early surgery or died during hospitalization had a significantly higher mean admission NT–pro-BNP than those who did not experience the primary end point.
In addition, compared with the prognostic value of NT–pro-BNP alone, we
References (20)
- et al.
Prognostic importance of atrial natriuretic peptide in patients with chronic heart failure
J Am Coll Cardiol
(1989) - et al.
B-type natriuretic peptide in cardiovascular disease
Lancet
(2003) - et al.
Cardiac troponins in congestive heart failure
Am Heart J
(1999) - et al.
Risk of embolization after institution of antibiotic therapy for infective endocarditis
J Am Coll Cardiol
(2002) - et al.
New criteria for the diagnosis of infective endocarditis: utilization of specific echocardiographic findings
Am J Med
(1994) - et al.
Role of troponin I in active infective endocarditis
Am J Cardiol
(2004) - et al.
B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with CKD: relationship to renal function and left ventricular hypertrophy
Am J Kidney Dis
(2005) - et al.
N-Terminal proatrial natriuretic factor: an independent predictor of long-term prognosis after myocardial infarction
Circulation
(1994) - et al.
Plasma alpha-atrial natriuretic peptide concentrations in acute respiratory failure associated with sepsis: preliminary study
Crit Care Med
(1990) - et al.
Increased human brain natriuretic peptide in congestive heart failure
N Engl J Med
(1990)
Cited by (59)
Biomarkers for prediction of mortality in left-sided infective endocarditis
2020, International Journal of Infectious DiseasesTowards identification of novel putative biomarkers for infective endocarditis by serum proteomic analysis
2020, International Journal of Infectious DiseasesTroponin elevation is very common in patients with infective endocarditis and is associated with a poor outcome
2020, International Journal of CardiologyCitation Excerpt :However, TnT levels allow reclassifying approximate one third of patients into their risk category of dying during hospital admission. A previous systematic review [6] of six original reports [7–12] suggests that cardiac troponin elevation is seen in the majority of IE patients (57–73%), with higher rates when high-sensitive assay was used [10]. Our study confirms these findings, particularly for patients with high-sensitive TnT (93%).
Forgotten Predictors of Prosthetic Valve Endocarditis
2016, Heart Lung and CirculationReply
2016, American Journal of CardiologyAtrial fibrillation in infective endocarditis
2016, American Journal of Cardiology
This study was supported by a grant from the Turkish Society of Cardiology, Istanbul, Turkey.