Author:
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Núñez, Julio; Núñez, Eduardo; Barallat, Jaume; Bodi, Vicente; Miñana, Gema; Pastor, M. Cruz; Sanchis, Juan; Lupón, Josep; Bayés-Genís, Antoni
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Abstract:
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Our aim was to evaluate the association between the soluble form of neprilysin () levels and long-term all-cause, cardiovascular, and acute heart failure () recurrent admissions in an ambulatory cohort of patients with heart failure. has emerged as a new biomarker with promising implications for prognosis and therapy in patients with heart failure. Reducing the recurrent admission rate of heart failure patients has become an important target of public health planning strategies. We measured levels in 1021 consecutive ambulatory heart failure patients. End points were the number of all-cause, cardiovascular, and hospitalizations during follow-up. We used covariate-adjusted incidence rate ratios to identify associations. At a median follow-up of 3.4 years (interquartile range: 1.8-5.7), 391 (38.3%) patients died, 477 (46.7%) patients had 1901 all-cause admissions, 324 (31.7%) patients had 770 cardiovascular admissions, and 218 (21.4%) patients had 488 admissions. The medians for and amino-terminal pro-brain natriuretic peptide were 0.64 ng/mL (interquartile range: 0.39-1.22) and 1248 pg/mL (interquartile range: 538-2825), respectively. In a multivariate setting, the adjusted incidence rate ratios for the top (>1.22 ng/mL) versus the bottom (≤0.39 ng/mL) quartiles of were 1.37 (95% confidence interval: 1.03-1.82), P =0.032; 1.51 (95% confidence interval: 1.10-2.06), P =0.010; and 1.51 (95% confidence interval: 1.05-2.16), P =0.026 for all-cause, cardiovascular, and admissions, respectively. Elevated levels predicted an increased risk of recurrent all-cause, cardiovascular, and admissions in ambulatory patients with heart failure. |