Academic Journal
Combined Prognostic Value of Follow-Up Ejection Fraction and Natriuretic Peptide Measurements in Heart Failure With Reduced Ejection Fraction Following Initiation of Pharmacotherapy.
| Τίτλος: | Combined Prognostic Value of Follow-Up Ejection Fraction and Natriuretic Peptide Measurements in Heart Failure With Reduced Ejection Fraction Following Initiation of Pharmacotherapy. |
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| Συγγραφείς: | Kodur N; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland OH USA., Gunsalus PR; Department of Quantitative Health Sciences Cleveland Clinic Research Cleveland OH USA., Milinovich A; Department of Quantitative Health Sciences Cleveland Clinic Research Cleveland OH USA., Dalton JE; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland OH USA.; Department of Quantitative Health Sciences Cleveland Clinic Research Cleveland OH USA., Tang WHW; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland OH USA.; Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic Cleveland OH USA. |
| Πηγή: | Journal of the American Heart Association [J Am Heart Assoc] 2026 Jun 02; Vol. 15 (11), pp. e047015. Date of Electronic Publication: 2026 May 25. |
| Τύπος έκδοσης: | Journal Article; Research Support, Non-U.S. Gov't |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford : Wiley-Blackwell |
| Ιατρικοί όροι (MeSH): | Heart Failure*/drug therapy , Heart Failure*/physiopathology , Heart Failure*/blood , Heart Failure*/diagnosis , Heart Failure*/mortality , Stroke Volume*/physiology , Natriuretic Peptide, Brain*/blood , Peptide Fragments*/blood , Ventricular Function, Left*/physiology, Biomarkers/blood ; Humans ; Prognosis ; Retrospective Studies ; Aged ; Female ; Male ; Middle Aged ; Predictive Value of Tests ; Time Factors |
| Περίληψη: | Background: Few studies have directly compared the prognostic value of left ventricular ejection fraction (LVEF) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) in patients with heart failure (HF) with reduced EF who have initiated guideline-directed medical therapy. This study sought to assess the combined prognostic value of follow-up LVEF and NT-proBNP measurements taken following initiation of guideline-directed medical therapy in patients with HF with reduced EF. Methods: This retrospective cohort study (2009-2024) conducted at a large, integrated health system included 6168 patients who had a diagnosis of HF with reduced EF (LVEF ≤40%) along with available LVEF and NT-proBNP measurements at ~9 months following diagnosis, which was defined as the study baseline. A composite outcome of HF hospitalization or all-cause death was assessed. Results: A large majority of patients were on at least 2 guideline-directed medical therapy medications at baseline. The median LVEF was 36% (interquartile range, 27-46), and the median NT-proBNP was 2161 pg/mL (interquartile range, 610-7350). Higher NT-proBNP levels were, in general, associated with a higher adjusted 1-year risk of the composite outcome across the spectrum of LVEF, with even mildly to moderately elevated NT-proBNP levels (125-1000 pg/mL) associated with incremental risk. Both LVEF and NT-proBNP offered independent prognostic information, but NT-proBNP had a much stronger association with the composite outcome and a much greater ability to discriminate between patients based on risk than LVEF (Δconcordance index: +0.129; 95% CI, 0.118-0.141), with LVEF offering only minimal prognostic value beyond NT-proBNP. Conclusions: Among patients with HF with reduced EF who have initiated guideline-directed medical therapy, NT-proBNP may offer much greater prognostic value than LVEF, with even mildly to moderately elevated NT-proBNP levels portending meaningful incremental risk. |
| Contributed Indexing: | Keywords: HFrEF; LVEF; NT‐proBNP; heart failure with reduced ejection fraction; left ventricular ejection fraction; natriuretic peptide |
| Substance Nomenclature: | 114471-18-0 (Natriuretic Peptide, Brain) 0 (Peptide Fragments) 0 (pro-brain natriuretic peptide (1-76)) 0 (Biomarkers) |
| Entry Date(s): | Date Created: 20260525 Date Completed: 20260606 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13315360 |
| DOI: | 10.1161/JAHA.125.047015 |
| PMID: | 42179256 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2047-9980 |
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| DOI: | 10.1161/JAHA.125.047015 |