Comparative cost-effectiveness of B-type natriuretic peptide and echocardiography for predicting outcome in patients with congestive heart failure.
نویسندگان
چکیده
Two-dimensional echocardiographic and Doppler variables and B-type natriuretic peptide (BNP) can predict outcomes in patients with congestive heart failure (CHF). However, there is a paucity of data on the relative cost-effectiveness of these modalities in predicting outcome. One hundred sixteen patients hospitalized with CHF underwent simultaneous BNP and Doppler echocardiographic examinations once ready for discharge. The ability of these variables to determine the primary end point (cardiac death or rehospitalization for CHF) was determined. The cost-effectiveness ratios (CER) of 2-dimensional variables, Doppler indexes, and BNP were calculated for prediction of the primary end point. Follow-up was completed in 110 of 116 patients at a mean of 527 days after hospital discharge. Fifty-four patients (50%) reached the primary end point (37 rehospitalizations for CHF and 17 cardiac deaths). When added to a history of admission to the hospital in the preceding year for CHF, a comprehensive Doppler echocardiographic study predicted 52 of 54 events, with a CER of 729.10 dollars, whereas BNP predicted 47 of 54 events (CER 49.98 dollars; p < 0.001 for CER comparison). In patients admitted to hospitals with CHF, predischarge BNP is more cost-effective than comprehensive Doppler echocardiographic examination for the prediction of future cardiac death or rehospitalization for CHF.
منابع مشابه
Comparative assessment of N-terminal pro-B-type natriuretic peptide, nitric oxide and echocardiography for diagnosis of dilated cardiomyopathy in dogs
The aim of the study was to evaluate the clinical usefulness of N-terminal pro-brain natriuretic peptide (NT-Pro BNP) and nitric oxide (NO) with echocardiography (gold standard test) in diagnosis of canine cardiomyopathy. Out of 374 cases, 82 cases showing cardiovascular abnormalities including 16 cases of cardiomyopathy were further selected for standardization of biomarkers. Significant (P
متن کاملClinical and Biochemical Assessments of Circulating B-Type Natriuretic Peptide as a Useful Marker in Pediatric Cardiac Patients
Background Although the left ventricle is the major site of BNP secretion in response to cardiac pressure or volume overload, the myocytes of both atria and ventricles secrete B- type natriuretic peptide (BNP). This study aimed to assess and compare the plasma levels of BNP in common pediatric cardiac diseases to clarify its pathophysiological role and evaluate its po...
متن کاملDiagnostic Value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP) in Cardiac Involvement in Patients with Beta- Thalassemia
Background Heart failure is a major cause of death in thalassemia. The study aimed to determine the diagnostic value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP), to early diagnose the cardiac involvement in beta- thalassemia major patients. Materials and Methods 80 thalassemia patients aged 7 to 18 years old (patients group), and 80 healthy age and gender matched controls were ...
متن کاملCost-effectiveness of N-terminal pro-B-type natriuretic-guided therapy in elderly heart failure patients: results from TIME-CHF (Trial of Intensified versus Standard Medical Therapy in Elderly Patients with Congestive Heart Failure).
OBJECTIVES This study aimed to assess cost-effectiveness of N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided versus symptom-guided therapy in heart failure (HF) patients ≥60 years old. BACKGROUND Cost-effectiveness of NT-proBNP guidance in HF patients is unclear. It may create additional costs with uncertain benefits. METHODS In the TIME-CHF (Trial of Intensified versus Standard...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- The American journal of cardiology
دوره 97 3 شماره
صفحات -
تاریخ انتشار 2006