The predictive value of N-terminal pro-brain natriuretic peptide for short-term mortality in patients with infective endocarditis complicated with sepsis
WANG Na
XIE Yin-jun
LIAO You-wan
ZHAN Xiu-jin
Abstract：Background: Elevated N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is a recognized predictor of poor prognosis in heart failure and infectious diseases. We aimed to investigate its predictive value for short-term mortality in patients with infective endocarditis (IE) complicated by sepsis. Methods: A total of 416 consecutive patients diagnosed with IE and sepsis at Guangdong Provincial People's Hospital were enrolled. The patients were divided into three groups according to the tertiles of NT-pro-BNP level of the first blood collection within 24 hours after admission: <2000 pg/mL (n=138), 2000-7167 pg/mL (n=140), and >7167 pg/mL (n=138). Univariate and multivariate regression analysis were used to explore the predictive value of NT-pro-BNP for short-term mortality, and the best cut-off value was determined by receiver operating characteristic (ROC) curve. Results: In-hospital and 6-month death occurred in 65 and 94 patients, respectively. Higher in-hospital mortality was found in patients with higher serum NT-pro-BNP levels (9.4% vs. 13.6% vs. 23.9%, P=0.003). ROC curve analysis identified an optimal NT-pro-BNP cutoff level of 1357 pg/mL [area under curve (AUC): 0.652, 95%CI: 0.588-0.717, P<0.001]. Multivariate regression analysis showed that both log-transformed NT-pro-BNP (in-hospital mortality: OR: 1.987, 95%CI: 1.045-3.778, P=0.036; 6-month mortality: HR: 1.714, 95%CI: 1.072-2.7400, P=0.025) and NT-pro-BNP>1357 pg/mL (in-hospital mortality: OR: 8.059, 95%CI: 1.813-35.818, P=0.006; 6-month mortality: HR: 5.193, 95%CI: 1.806-14.938, P=0.002) were both independent risk factors for in-hospital and 6-month mortality. Conclusions: Serum NT-pro-BNP could serve as an independent predictor of in-hospital and 6-month mortality in patients with IE complicated with sepsis.
Keywords：Infective endocarditisSepsisN-terminal pro-brain natriuretic peptideMortality
Publication Date：2025-06-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 121-127,封3 )