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Browsing by Author "Hosgun, Derya"

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    Article
    Do N-Terminal Pro-Brain Natriuretic Peptide Levels Determine the Prognosis of Community Acquired Pneumonia
    (Soc Brasileira Pneumologia Tisiologia, 2019) Akpinar, Evrim Eylem; Hosgun, Derya; Akpinar, Serdar; Ates, Can; Baha, Ayse; Gulensoy, Esen Sayin; Ogan, Nalan
    Objective: Pneumonia is a leading cause of mortality worldwide, especially in the elderly. The use of clinical risk scores to determine prognosis is complex and therefore leads to errors in clinical practice. Pneumonia can cause increases in the levels of cardiac biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP). The prognostic role of the NT-proBNP level in community acquired pneumonia (CAP) remains unclear. The aim of this study was to evaluate the prognostic role of the NT-proBNP level in patients with CAP, as well as its correlation with clinical risk scores. Methods: Consecutive inpatients with CAP were enrolled in the study. At hospital admission, venous blood samples were collected for the evaluation of NT-proBNP levels. The Pneumonia Severity Index (PSI) and the Confusion, Urea, Respiratory rate, Blood pressure, and age = 65 years (CURB-65) score were calculated. The primary outcome of interest was all-cause mortality within the first 30 days after hospital admission, and a secondary outcome was ICU admission. Results: The NT-proBNP level was one of the best predictors of 30-day mortality, with an area under the curve (AUC) of 0.735 (95% CI: 0.642-0.828; p < 0.001), as was the PSI, which had an AUC of 0.739 (95% CI: 0.634-0.843; p < 0.001), whereas the CURB-65 had an AUC of only 0.659 (95% CI: 0.556-0.763; p = 0.006). The NT-proBNP cut-off level found to be the best predictor of ICU admission and 30day mortality was 1,434.5 pg/mL. Conclusions: The NT-proBNP level appears to be a good predictor of ICU admission and 30-day mortality among inpatients with CAP, with a predictive value for mortality comparable to that of the PSI and better than that of the CURB-65 score.
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    Article
    Impairment in Heart Functions and Prognostic Role of N-Terminal Pro-Brain Natriuretic Peptide in Patients With Chronic Obstructive Pulmonary Disease Exacerbation
    (Wolters Kluwer Medknow Publications, 2020) Akpinar, Evrim Eylem; Ates, Can; Akpinar, Serdar; Hosgun, Derya
    INTRODUCTION: Chronic obstructive pulmonary disease (COPD) with comorbidities and cardiovascular disease is the most frequent one. The role of natriuretic peptides in determining prognosis of COPD exacerbations is not yet clear. The frequency of pathologic findings of transthoracic echocardiography (TTE) during COPD exacerbation showed wide variability. This study aims to evaluate the predictive role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in determining the short-term prognosis of patients hospitalized with COPD exacerbation. As a secondary outcome, we aimed to investigate the frequency of TTE findings in these patients. MATERIALS AND METHODS: Eighty-six consecutive patients with COPD exacerbation were included. NT-proBNP levels were measured and TTE was carried out to whole of the participants at administration. The primary outcome was development of "event" (readmission or rehospitalization or mortality) within 30 days. The predictive role of NT-proBNP level for the development of "event" was evaluated. As a secondary outcome of the study, the frequency of TTE findings was recorded. RESULTS: NT-proBNP level of the patients who developed event within 30 days had significantly higher than who did not (2343.16 +/- 4107.17 pg/mL vs. 843.22 +/- 2349.96 pg/mL, P = 0.001). A high negative correlation was found between NT-proBNP level and "time to event" (r = -0.992, P < 0.001). Multivariable logistic regression analysis showed that NT-proBNP level was an independent predictor for the development of "event" (P < 0.001) and the cutoff point of it was found to be 303.5 pg/mL (0.639 sensitivity and 0.720 specificity). The most frequent echocardiographic findings were pulmonary hypertension (54.7%) and left ventricle diastolic dysfunction (39.5%). CONCLUSION: NT-proBNP level is a strong predictor for short-term prognosis of patients hospitalized with COPD exacerbation. Further and larger studies are needed to determine exact role of NT-proBNP in long-term prognosis of these patients.