Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/11221
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dc.contributor.authorJarai, Rudolf-
dc.contributor.authorHuber, Kurt-
dc.contributor.authorBOGAERTS, Kris-
dc.contributor.authorSinnaeve, Peter R.-
dc.contributor.authorEzekowitz, Justin-
dc.contributor.authorRoss, Allan M.-
dc.contributor.authorZeymer, Uwe-
dc.contributor.authorArmstrong, Paul W.-
dc.contributor.authorVan de Werf, Frans J.-
dc.date.accessioned2010-10-05T11:04:42Z-
dc.date.availableNO_RESTRICTION-
dc.date.available2010-10-05T11:04:42Z-
dc.date.issued2010-
dc.identifier.citationCRITICAL CARE MEDICINE, 38 (9). p. 1793-1801-
dc.identifier.issn0090-3493-
dc.identifier.urihttp://hdl.handle.net/1942/11221-
dc.description.abstractObjective: Cardiogenic shock is a major cause of death in ST elevation myocardial infarction. We investigated whether determination of B-type natriuretic peptide and the N-terminal fragment of its pro-hormone in the acute phase of ST elevation myocardial infarction could identify patients prone to development of cardiogenic shock. Design: Retrospective analysis of a multicenter, randomized open-label trial (ASSENT-4 PCI; ClinicalTrials.gov Identifier: NCT00168792). Methods: Plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone were determined in available stored samples of 1016 ST elevation myocardial infarction patients without signs of cardiogenic shock at randomization to primary percutaneous coronary intervention or to full-dose tenecteplase before percutaneous coronary intervention. The end point of the present analysis was in-hospital cardiogenic shock. Interventions: None. Measurements and Main Results: In total, 57 (5.6%) patients had cardiogenic shock during index hospitalization. In-hospital cardiogenic shock increased precipitously with higher baseline concentrations of plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone (B-type natriuretic peptide and the N-terminal fragment of its pro-hormone <= 67 pg/mL: 1.9%; 68-1482 pg/mL: 5.9%; > 1482 pg/mL: 14.9%; p < .001). Higher B-type natriuretic peptide and the N-terminal fragment of its pro-hormone concentrations were predictors of in-hospital shock, especially among those patients with relatively low clinical risk (no requirement of inotropic support before angiography, systolic blood pressure > 100 mm Hg, heart rate < 100 bpm, Global Utilization of Streptikonase and Tissue-Plasminogen Activator for Occluded Coronary Arteries score of < 122). In multivariate Cox regression analysis, higher plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone concentrations remained significant predictors of shock, in addition to age, systolic blood pressure, heart rate, and randomization to facilitated percutaneous coronary intervention and Killip classification. Furthermore, plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone significantly predicted in-hospital shock independently of the validated Global Utilization of Streptikonase and Tissue-Plasminogen Activator for Occluded Coronary Arteries score (p = .014). Conclusion: Plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone concentrations measured early in the acute phase of ST elevation myocardial infarction are useful in predicting the development of in-hospital cardiogenic shock. (Crit Care Med 2010; 38:1793-1801)-
dc.language.isoen-
dc.publisherLIPPINCOTT WILLIAMS & WILKINS-
dc.subject.othercardiogenic shock; B-type natriuretic peptide; ST-elevation myocardial infarction-
dc.subject.othercardiogenic shock; B-type natriuretic peptide; ST-elevation myocardial infarction-
dc.titlePrediction of cardiogenic shock using plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone concentrations in ST elevation myocardial infarction: An analysis from the ASSENT-4 Percutaneous Coronary Intervention Trial-
dc.typeJournal Contribution-
dc.identifier.epage1801-
dc.identifier.issue9-
dc.identifier.spage1793-
dc.identifier.volume38-
local.format.pages9-
local.bibliographicCitation.jcatA1-
dc.description.notes[Jarai, Rudolf; Huber, Kurt] Wilhelminen Hosp, Dept Med Cardiol & Emergency Med 3, Vienna, Austria. [Bogaerts, Kris] Katholieke Univ Leuven, Interuniv Inst Biostat & Stat Biostat I Biostat, Louvain, Belgium. [Bogaerts, Kris] Univ Hasselt, Hasselt, Belgium. [Sinnaeve, Peter R.] Univ Hosp, Dept Cardiol, Louvain, Belgium. [Ezekowitz, Justin] Univ Alberta Hosp, Mazankowski Alberta Heart Inst, Edmonton, AB T6G 2B7, Canada. [Ross, Allan M.] Duke Clin Res Unit, Div Cardiol, Durham, NC USA. [Zeymer, Uwe] Herzzentrum Ludwigshafen, Med Klin B, Ludwigshafen, Germany. [Armstrong, Paul W.] Univ Alberta, Edmonton, AB, Canada. kurt.huber@wienkav.at-
local.type.refereedRefereed-
local.type.specifiedArticle-
dc.bibliographicCitation.oldjcatA1-
dc.identifier.doi10.1097/CCM.0b013e3181eaaf2a-
dc.identifier.isi000281559500004-
item.accessRightsClosed Access-
item.fulltextNo Fulltext-
item.validationecoom 2011-
item.contributorJarai, Rudolf-
item.contributorHuber, Kurt-
item.contributorBOGAERTS, Kris-
item.contributorSinnaeve, Peter R.-
item.contributorEzekowitz, Justin-
item.contributorRoss, Allan M.-
item.contributorZeymer, Uwe-
item.contributorArmstrong, Paul W.-
item.contributorVan de Werf, Frans J.-
item.fullcitationJarai, Rudolf; Huber, Kurt; BOGAERTS, Kris; Sinnaeve, Peter R.; Ezekowitz, Justin; Ross, Allan M.; Zeymer, Uwe; Armstrong, Paul W. & Van de Werf, Frans J. (2010) Prediction of cardiogenic shock using plasma B-type natriuretic peptide and the N-terminal fragment of its pro-hormone concentrations in ST elevation myocardial infarction: An analysis from the ASSENT-4 Percutaneous Coronary Intervention Trial. In: CRITICAL CARE MEDICINE, 38 (9). p. 1793-1801.-
crisitem.journal.issn0090-3493-
crisitem.journal.eissn1530-0293-
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