NT-proBNP un marker important în algoritmul diagnostic la pacienții cu fibrilație atrială non valvulara și insuficiență cardiacă

Abstract

Rezumat. Obiective. Pacienții cu fibrilație atrială prezintă un risc crescut de insuficiență cardiacă, precum și de accident vascular cerebral ischemic. Este foarte important urmărirea nivelului plasmatic al hormonului natriuretic NT-proBNP, care a fost cristalizat ca principal biomarker care semnalizează prezenţa insuficienţei cardiace, mai ales în stadiile incipiente. Scopul lucrării constă în estimarea clinico-diagnostică a biomarkerului NT-proBNP la pacienți cu fibrilație atrială non-valvulară și insuficiență cardiacă. Materiale și metode. În studiu au fost incluși 40 pacienți cu fibrilație atrială non-valvulară, internați în secția Cardiologie a IMSP Spitalul Clinic Municipal ”Sfânta Treime”, în perioada decembrie 2022 – iunie 2023. Pacienții incluși în cercetare au întrunit criteriile de includere în studiu (acordul pacientului cu semnarea consimțământului informat, vârsta, pacienții cu fibrilație atrială non-valvulară permanentă și persistentă aflați la tratament cu Warfarină). Rezultate și discuții. Studiul include pacienții cu vârste cuprinse între 50 și 90 de ani, cu o medie de 66,98±1,29, genului feminin revenindu-i o pondere de 42,5% (17 persoane), iar genului masculin – 57,5 % (23 persoane). Greutatea medie la bărbați constituie 91,08 kg și la femei 91,35 kg. Valorile medii ale NT-proBNP la internare în staționar constituie 3349,965±661.23 pg/ml și după o lună de tratament – 2629,681±733.3076 pg/ml. Concluzii. Conform rezultatelor obținute putem confirma că markerul NT-proBNP este un test foarte important, rapid (15 minute) şi fiabil. Nivelul seric al acestui marker creşte cel mai mult în cazul insuficienţei cardiace, care este diagnosticată la toți pacienții din studiul nostru cu fibrilație atrială non-valvulară forma permanentă și persistentă.

Summary. Objectives. Patients with atrial fibrillation have an increased risk of heart failure as well as ischemic stroke. It is very important to monitor the plasma level of the natriuretic hormone NT-proBNP, which has been crystallized as the main biomarker that signals the presence of heart failure, especially in the early stages. The aim of the work consists in the clinical-diagnostic estimation of the NT-proBNP biomarker in patients with non-valvular atrial fibrillation and heart failure. Materials and methods. In the study were included 40 patients with non-valvular atrial fibrillation, hospitalized in the Cardiology department of the Municipal Clinical Hospital ”Sfânta Treime”, between December 2022 and June 2023. The patients included in the research met the criteria for inclusion in the study (the patient's agreement with the signing of the informed consent, age, patients with permanent and persistent non-valvular atrial fibrillation treated with Warfarin). Results and discussions. The study includes patients aged between 50 and 90 years with an average age of 66.98±1.29, the female gender including 42.5% (17 people), and the male gender – 57.5% (23 people). The average weight for men is 91.08 kg and for women – 91.35 kg. The average values of NT-proBNP at hospitalization are 3349.965±661.23 pg/ml and after one month of treatment – 2629.681±733.3076 pg/ml. Conclusions. According to the results obtained, we can confirm that the NT-proBNP marker is a very important, fast (15 minutes) and reliable test. The serum level of this marker increases the most in the case of heart failure, which is diagnosed in all patients in our study with permanent and persistent non-valvular AF.

Summary. Objectives. Patients with atrial fibrillation have an increased risk of heart failure as well as ischemic stroke. It is very important to monitor the plasma level of the natriuretic hormone NT-proBNP, which has been crystallized as the main biomarker that signals the presence of heart failure, especially in the early stages. The aim of the work consists in the clinical-diagnostic estimation of the NT-proBNP biomarker in patients with non-valvular atrial fibrillation and heart failure. Materials and methods. In the study were included 40 patients with non-valvular atrial fibrillation, hospitalized in the Cardiology department of the Municipal Clinical Hospital ”Sfânta Treime”, between December 2022 and June 2023. The patients included in the research met the criteria for inclusion in the study (the patient's agreement with the signing of the informed consent, age, patients with permanent and persistent non-valvular atrial fibrillation treated with Warfarin). Results and discussions. The study includes patients aged between 50 and 90 years with an average age of 66.98±1.29, the female gender including 42.5% (17 people), and the male gender – 57.5% (23 people). The average weight for men is 91.08 kg and for women – 91.35 kg. The average values of NT-proBNP at hospitalization are 3349.965±661.23 pg/ml and after one month of treatment – 2629.681±733.3076 pg/ml. Conclusions. According to the results obtained, we can confirm that the NT-proBNP marker is a very important, fast (15 minutes) and reliable test. The serum level of this marker increases the most in the case of heart failure, which is diagnosed in all patients in our study with permanent and persistent non-valvular AF.