REINE RISA RISTHANTI, 051315153010 (2016) PERUBAHAN KADAR NT-proBNP PASCA TERAPI KOMBINASI β-BLOKER DAN ACE-INHIBITOR PADA PASIEN GAGAL JANTUNG (Penelitian dilaksanakan di Poli Jantung RSUD Dr. Soetomo Surabaya). Thesis thesis, Universitas Airlangga.

Preview	Text (abstrak) TFK. 03-16 Ris p abstrak.pdf Download (27kB) | Preview
	Text (fulltext) TFK. 03-16 Ris p.pdf Restricted to Registered users only Download (1MB) | Request a copy

Abstract

Background : Heart failure (HF) is the final common stage of many diseases of the heart. NTproBNP levels are increased in HF and correlate well with ventricular wall stress and severity of HF. The prognostic power of NT-proBNP is well established in heart failure patients. Higher concentrations of NT-proBNP are associated with increased cardiovascular events and all cause mortality. Combination therapy with Bisoprolol and ACE-inhibitor decreases NT-proBNP level in patient with HF. The use of Bisoprolol as a combination with ACE-inhibitor is still dominate in outpatient setting at Dr. Soetomo teaching hospital. Objective : The objective of this study is to analyze NT-proBNP level changes as an indicator in cardiac function after combination therapy with Bisoprolol and ACE-inhibitor in patient with HF. Methods : This study was prospective, observational and conducted in outpatient setting. Consecutive patients who meet the inclusion criteria of the study were included. Blood samples were taken at pre and 2 months post combination therapy with Bisoprolol and ACE-inhibitor, then NT-proBNP level was measured with IMMULITE®. Ethical clearance of this study was held at Dr. Soetomo Teaching Hospital. Result : There were 14 patients enrolled in this study (7 males, 7 females). The result showed that NT-proBNP 2 months post combination therapy with Bisoprolol and ACE-inhibitor is significantly decreased than baseline with mean baseline of NT-proBNP level is 4191.43 ± 4367.277 pg/ml to 2786.79 ± 2485.199 pg/ml (p=0.025). NT-proBNP levels decrease by 20%-80% of baseline or below the cutpoint <1000 pg/ml in outpatient setting can reduce the risk of death, transplantation, and the incidence of hospital admission. From a total 14 patients, 9 patients had NT-proBNP decreases >20% (20.1% – 56.4%) and 3 patients had NT-proBNP decreases <20% (1.8%; 6.6%; and 12.4%). There were 2 patients with NT-proBNP increases >40% (43.4% and 40.4%). Conclusion : There was a significant decreases in NT-proBNP level after 2 months combination therapy with Bisoprolol and ACE-inhibitor in patient with HF. Keywords : NT-proBNP, heart failure, Bisoprolol, Angiotensin-converting enzyme inhibitors

Actions (login required)

View Item