Cytokine | 2019
Value of N-terminal pro-brain natriuretic peptide and aortic diameter in predicting in-hospital mortality in acute aortic dissection.
Abstract
OBJECTIVE\nTo determine the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and aortic diameter in predicting in-hospital mortality in acute aortic dissection (AD).\n\n\nMETHODS\nA single-center prospective study was designed in the setting of University hospital in China. 122 patients with acute AD were enrolled. Admission plasma NT-proBNP levels and aortic diameter were measured.\n\n\nRESULTS\nPlasma NT-proBNP concentrations (P\u202f<\u202f0.001), aortic diameter (P\u202f=\u202f0.002), and admission systolic blood pressure (SBP) (P\u202f=\u202f0.011) were significantly increased in patients who died compared to those who survived during hospitalization. Furthermore, aortic diameter had positive correlations with NT-proBNP levels (r\u202f=\u202f0.270, P\u202f=\u202f0.003) and admission diastolic blood pressure (DBP) (r\u202f=\u202f0.202, P\u202f=\u202f0.025), respectively. Multiple logistic regression analysis demonstrated that NT-proBNP ≥569.75\u202fpg/ml and aortic diameter ≥40\u202fmm were strongly associated with in-hospital mortality. The odds ratio (OR) and 95% confidence interval (CI) were 3.246, 1.212-8.693 (P\u202f=\u202f0.019); and 2.917, 1.102-7.722 (P\u202f=\u202f0.031), respectively. Moreover, when NT-proBNP ≥1325.6\u202fpg/ml, the sensitivity and specificity of NT-proBNP in predicting in-hospital mortality risk were 55.2% and 95.7% (95% CI, 0.707-0.891; P\u202f<\u202f0.001), respectively. In addition, when aortic diameter ≥47\u202fmm, the sensitivity and specificity were 58.6% and 88.2% (95% CI, 0.607-0.841; P\u202f<\u202f0.001), respectively.\n\n\nCONCLUSIONS\nNT-proBNP ≥569.75\u202fpg/ml and aortic diameter ≥40\u202fmm were important risk factors and independently associated with acute AD in-hospital mortality. NT-proBNP ≥1325.6\u202fpg/ml or aortic diameter ≥47\u202fmm showed higher specificity in predicting in-hospital mortality. Using NT-proBNP and aortic diameter together showed better performance in predicting in-hospital mortality with higher sensitivity.