Prognostic value of N-terminal pro-B-type natriuretic peptide in patients with active infective endocarditis

Kahveci G., Bayrak F. , Mutlu B., Bitigen A., Karaahmet T. , Sonmez K., ...More

AMERICAN JOURNAL OF CARDIOLOGY, vol.99, no.10, pp.1429-1433, 2007 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 99 Issue: 10
  • Publication Date: 2007
  • Doi Number: 10.1016/j.amjcard.2006.12.071
  • Page Numbers: pp.1429-1433


Our aim was to determine whether N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and cardiac troponin I (cTnI) levels are valuable for predicting prognosis in patients with infective endocarditis (IE). We analyzed measured plasma NT-pro-BNP levels at admission in 45 patients with definite IE. The primary end point was early surgery or in-hospital death. The other data recorded were baseline clinical, echocardiographic, and laboratory parameters. Thirty patients underwent early surgery, and 9 died in hospital. Univariate analysis revealed that log NT-pro-BNP, cTnI >= 0.03 ng/ml, New York Heart Association functional class III to IV symptoms, left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and severe valvular regurgitation were associated with increased risk of reaching the primary end point. Cox proportional hazard regression analysis identified log NT-pro-BNP (hazard ratio 1.5; 95% confidence interval 1.2 to 1.9, p < 0.001) as the only independent predictor of the primary end point. The log NT-pro-BNP cut-off value with the highest sensitivity (97%) and specificity (92%) for predicting primary end point was 7.2 (1,500 pg/ml). Patients with NT-pro-BNP level > 1,500 pg/ml had significantly lower event-free survival than others. In conclusion, admission NT-pro-BNP is of prognostic value in patients with IE. The combination of admission NT-pro-BNP and -cTnI levels appears to have even greater value for risk stratification in this patient group. (c) 2007 Elsevier Inc. All rights reserved.