Predicting cardiogenic pulmonary edema in heart failure patients by using an N-terminal pro-b-type natriuretic peptide (NT-pro BNP) -based score

• Published in: Clinica chimica acta 2018-05, Vol.480, p.26-33
• Main Authors: Liu, Xin-Yi, Huang, Ya-Ting, Lai, Min-Yu, Chen, John, Chu, Tung-Wei, Tsay, Pei-Kwei, Shiao, Chih-Chung
• Format: Article
• Language: English
• Subjects: Cardiogenic pulmonary edema; Heart failure; NT-pro-BNP; Scoring system
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2018.01.042

Cardiogenic pulmonary edema (CPE) is a life-threatening emergency necessitating aggressive management. We conducted this study to test the hypothesis that a combination of N-terminal pro-b-type natriuretic peptide (NT-pro-BNP) and some relevant clinical factors may provide better predictability for CPE in heart failure (HF) patients. This retrospective study enrolled adult HF patients hospitalized during January 2011 to December 2013. After determining the independent predictors for the occurrence of CPE, a novel NT-pro BNP-based diagnostic score for predicting CPE was established. A total of 269 patients (mean age, 74.5 ± 13.6 years; female, 53.9%) were enrolled, and categorized into CPE group (n = 80, 29.7%) and non-CPE group (n = 189, 70.3%). Several factors such as “Serum NT-pro-BNP level > 6980 mg/dl,” “systemic blood pressure > 170 mm Hg,” “heart rate > 120 bpm,” “with rales in breathing sound,” “with jugular vein engorgement,” “with NYHA Fc III/IV,” “with chronic lung disease” and “with angiotensin converting enzyme inhibitors/angiotensin receptor blocker” were found to be associated with the existence of CPE. A novel NT-pro BNP based scoring system containing these risk factors was proposed and proven excellent in predicting CPE. The NT-pro-BNP scoring system could predict CPE in HF patients. •A novel N-terminal pro-b-type natriuretic peptide based scoring system excellently predicts cardiogenic pulmonary edema.