1. N-terminal pro-B-type natriuretic peptide predicts cardiovascular complications in pregnant women with congenital heart disease
- Author
-
Kampman, M.A.M., Balci, A., Veldhuisen, D.J. van, Dijk, A.P.J. van, Roos-Hesselink, J.W., Sollie-Szarynska, K.M., Ludwig-Ruitenberg, M., Melle, J.P. van, Mulder, B.J., Pieper, P.G., Cardiology, Cardiovascular Centre (CVC), and ACS - Amsterdam Cardiovascular Sciences
- Subjects
Adult ,Heart Defects, Congenital ,medicine.medical_specialty ,Heart disease ,medicine.drug_class ,Pregnancy Complications, Cardiovascular ,GUIDELINES ,RECOMMENDATIONS ,ECHOCARDIOGRAPHIC-ASSESSMENT ,Pregnancy ,Prenatal Diagnosis ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Humans ,FAILURE ,Prospective Studies ,Natriuretic peptides ,Congenital heart disease ,AMERICAN-SOCIETY ,CARDIOLOGY ,OUTCOMES ,VALVES ,business.industry ,MORTALITY ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Area under the curve ,Prenatal Care ,Odds ratio ,medicine.disease ,Right ventricular function ,Peptide Fragments ,EUROPEAN-SOCIETY ,Cardiology ,Gestation ,Female ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business ,Biomarkers ,Cohort study - Abstract
Contains fulltext : 133839.pdf (Publisher’s version ) (Closed access) AIMS: In women with congenital heart disease (CHD), cardiovascular complications during pregnancy are common, but the risk assessment of these patients remains difficult. This study sought to determine the independent role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in addition to other parameters in predicting adverse cardiovascular events during pregnancy in women with CHD. METHODS AND RESULTS: We conducted a national, prospective multicentre cohort study. Follow-up with clinical evaluation and echocardiography and NT-proBNP measurement was performed at 20-week gestation. Adverse cardiovascular events occurred in 10.3% of 213 pregnancies. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20-week gestation, the presence of a mechanical valve, and subpulmonary ventricular dysfunction before conception were independently associated with events [odds ratio (OR) 10.6 (P = 0.039), OR 12.0 (P = 0.016), and OR 4.2 (P = 0.041), respectively]. The negative predictive value of NT-proBNP levels 128 pg/mL at 20 weeks of gestation had an additional value in predicting the occurrence of adverse cardiovascular events on the top of the other identified predictors (area under the curve 0.90 vs. 0.78, P = 0.035). CONCLUSION: Increased NT-proBNP levels at 20 weeks of gestation are an independent risk predictor of cardiovascular events during pregnancy in women with CHD.
- Published
- 2014
- Full Text
- View/download PDF