心脏生物标志物 - 副本.ppt

BNP医保收费252元 Athough patients in the NT-proBNP arm ended the trial on higher doses of medications overall, the primary endpoint of mortality, depicted here, suggested that there was no significant difference between the clinical and NT-proBNP arms. Why might NT-proBNP guide therapy in the outpatient setting? As with acute heart failure, NT-proBNP concentrations are powerfully indicative of HF status and prognosis and are useful across the entire spectrum of HF stages. As with all other venues, serial testing is more powerful than a single measurement to identify risk. Why might NT-proBNP guide therapy in the outpatient setting? As with acute heart failure, NT-proBNP concentrations are powerfully indicative of HF status and prognosis and are useful across the entire spectrum of HF stages. As with all other venues, serial testing is more powerful than a single measurement to identify risk. 1 year mortality Ideal cut-point: 986 pg/mL Importantly, however, the Val-HeFT investigators then examined the merits of single NT-proBNP measurement versus serial measurements for risk prediction and found that serial measurements over time were associated with superior risk stratification compared to a single measurement. When evaluating patients with two blood draws spaced 4 months apart, patients who either had low measurements at both blood draws or two high measurements at both blood draws had predictably low and high rates of adverse outcome. However, patients who started out with low values (NT-proBNP below ~1000 pg/mL) but rose above this threshold over the 4 months of follow up had worse outcomes than patients who started out with an NT-proBNP above ~1000 pg/mL and fell over the follow up period of the study. This implies that a significant percentage of patients would be incorrectly assessed for their risk profile if only one measurement of NT-proBNP was made. Furthermore, as therapies for heart failure have direct effects on concentrations of NT-proBNP, the tr