Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Original Article

Volume 13, Number 2, April 2022, pages 73-80

The Association of N-Terminal Pro-Brain Natriuretic Peptide With Time to Clinical Worsening in Hispanic Patients With Pulmonary Arterial Hypertension

Figures

Figure 1.
Figure 1. NT-proBNP levels in patients with and without CKD. NT-proBNP: N-terminal pro-brain natriuretic peptide; CKD: chronic kidney disease.
Figure 2.
Figure 2. Kaplan Meier Plot in all patients with NT-proBNP levels below or above 300 ng/L. TTCW: time to clinical worsening; NT-proBNP: N-terminal pro-brain natriuretic peptide.
Figure 3.
Figure 3. Kaplan Meier Plot in all patients with NT-proBNP levels below or above 1,415 ng/L. TTCW: time to clinical worsening; NT-proBNP: N-terminal pro-brain natriuretic peptide.
Figure 4.
Figure 4. Receiver operating characteristic curve analysis of baseline NT-proBNP levels to predict 1-year time to clinical worsening (TTCW) in all patients. NT-proBNP: N-terminal pro-brain natriuretic peptide; AUC: area under the curve; TTCW: time to clinical worsening.
Figure 5.
Figure 5. Kaplan Meier Plot in patients with CKD and BNP levels below or above 1,415 ng/L. TTCW: time to clinical worsening; NT-proBNP: N-terminal pro-brain natriuretic peptide.

Tables

Table 1. Baseline Characteristics in Patients With and Without Clinical Worsening
 
All patients (n = 115)No clinical worsening (n = 89)Clinical worsening (n = 26)P value
BMI: body mass index; WHO-FC: World Health Organization-Functional Classification; mRAP: mean right atrial pressure; mPAP: mean pulmonary arterial pressure; PCWP: pulmonary capillary wedge pressure; CO: cardiac output; 6MWD: 6-min walk distance; NT-proBNP: N-terminal pro-brain natriuretic peptide; SCr: serum creatinine.
Age (years)52 (46 - 68)50 (44 - 69)61 (48 - 69)0.14
Female (%)6772580.53
BMI (kg/m2)
WHO-FC (I - IV)2.5 ± 0.82.0 ± 0.52.9 ± 0.6< 0.05
mRAP (mm Hg)9 (6 - 14)8 (6 - 13)11.5 (8 - 18)< 0.05
mPAP (mm Hg)40 (29 - 51)37 (27 - 50)43 (35 - 51)0.13
PCWP (mm Hg)11 (7 - 14)11 (6 - 12)11.5 (9 - 14)0.66
CO (L/min)5.4 (4.2 - 6.7)5.4 (3.8 - 5.3)5.0 (3.2 - 5.2)0.78
6MWD (m)389 (282 - 450)396 (297 - 453)288 (187 - 364)< 0.05
NT-proBNP (ng/L)486 (135 - 2,540)242 (118 - 1,210)3,585 (1,840 - 6,893)< 0.05
SCr (mg/dL)1.04 (0.6 - 1.2)0.8 (0.6 - 1.1)1.1 (0.6 - 1.4)0.81

 

Table 2. Pulmonary Arterial Hypertension Targeted Therapies at Baseline Visit
 
No CKD (n = 88)CKD (n = 27)
CKD: chronic kidney disease; PDE5-i: phosphodiesterase type 5 inhibitors; ERAs: endothelin receptor antagonists.
PDE5-i88 (100%)27 (100%)
ERAs65 (74%)21 (77%)
Prostacyclin17(19%)4 (14%)
Mono-therapy23 (26%)6 (23%)
Double combination therapy48 (55%)17 (63%)
Triple combination therapy17 (19%)4 (14%)

 

Table 3. Baseline Characteristics in Patients With and Without CKD
 
VariablesAll patients (n = 115)No CKD (n = 88)CKD (n = 27)P value
CKD: chronic kidney disease; BMI: body mass index; WHO-FC: World Health Organization-Functional Classification; mRAP: mean right atrial pressure; mPAP: mean pulmonary arterial pressure; PCWP: pulmonary capillary wedge pressure; CO: cardiac output; 6MWD: 6-min walk distance; NT-proBNP: N-terminal pro-brain natriuretic peptide; SCr: serum creatinine.
Age (years)52 (46 - 68)53 (44 - 69)56 (48 - 61)0.28
Female (%)6776510.31
BMI (kg/m2)
WHO-FC (I - IV)2.5 ± 0.82.0 ± 0.63.0 ± 0.7< 0.05
mRAP (mm Hg)9 (6 - 14)8 (5 - 14)10 (8 - 16)0.60
mPAP (mm Hg)40 (29 - 51)38 (29 - 50)39 (32 - 52)0.88
PCWP (mm Hg)11 (7 - 14)10 (4 - 7)13 (10 - 14)0.62
CO (L/min)5.4 (4.2 - 6.7)5.3 (4 - 7)4.6 (3.9 - 5.8)0.74
6MWD (m)389 (282 - 450)389 (306 - 503)326 (300 - 399)0.21
NT-proBNP (ng/L)486 (135 - 2,540)381 (122 - 1,940)1,188 (235 - 3,240)< 0.05
SCr (mg/dL)1.04 (0.6 - 1.2)0.7 (0.6 - 0.8)1.3 (1.1 - 2.1)< 0.05