N-terminal pro brain natriuretic peptide in the management of patients in the medical emergency department (PROMPT): correlation with disease severity, utilization of hospital resources, and prognosis in a large, prospective, randomized multicentre trial

作者：Luchner Andreas^*; Moeckel Martin; Spanuth Eberhard; Moecks Joachim; Peetz Dirk; Baum Hannsjoerg; Spes Christoph; Wrede Christian E; Vollert Joern; Mueller Reinhold; Katus Hugo; Giannitsis Evangelos

来源：European Journal of Heart Failure, 2012, 14(3): 259-267.

DOI：10.1093/eurjhf/hfr171

• NT-proBNP
• Natriuretic peptide
• Emergency department
• Hospitalization
• Outcomes

N-terminal pro brain natriuretic peptide (NT-proBNP) is a potent marker of heart failure and other cardiac diseases. The value of NT-proBNP testing in the medical emergency department (ED) was assessed in patients 65 years old. %26lt;br%26gt;This large, prospective, randomized, controlled, multicentre trial was conducted in six medical EDs. Data for evaluation of the primary endpoint of hospitalization were available for 1086 patients. Median NT-proBNP was 582 pg/mL. A total of 16 of patients presented with NT-proBNP 150 pg/mL (low), 55 with NT-proBNP between 150 and 1800 pg/mL (intermediate), and 29 with NT-proBNP 1800 pg/mL (high). NT-proBNP was positively correlated with hospital admission [ odds ratio (OR) for high vs. low 2.9, P 0.0001], length of stay (8.5 days vs. 3.5 days for high vs. low, P 0.01), in-hospital death (3.9 vs. 0 for high vs. low, P 0.01), 6 months re-hospitalization (OR for high vs. low 5.1, P 0.0001), and 6 months death or re-hospitalization (OR for high vs. low 5.7, P 0.0001). Knowledge of NT-proBNP had no significant effect on the primary endpoint hospital admission and the secondary endpoints intermediate/intensive care unit (IMC/ICU) admission, length of stay, re-hospitalization and death, or re-hospitalization in the total cohort. However, patients with high open NT-proBNP (1800 pg/mL) were more likely to be admitted to the hospital (P 0.05) and IMC/ICU (P 0.05), whereas patients with low open NT-proBNP (150 pg/mL) were less likely to be admitted (P 0.05) compared with patients with blinded NT-proBNP. %26lt;br%26gt;Although NT-proBNP does not affect overall hospitalization, it is associated with better stratification of patient care and is strongly correlated with subsequent utilization of hospital resources and prognosis.

• 出版日期2012-3