Timing of Immunoreactive B-Type Natriuretic Peptide Levels and Treatment Delay in Acute Decompensated Heart FailureAn ADHERE (Acute Decompensated Heart Failure National Registry) Analysis
Alan S. Maisel, MD, FACC*, ,*,
William F. Peacock, MD ,
N. McMullin, MD,
Robert Jessie, MD, FACC ,
Gregg C. Fonarow, MD, FACC¶,
Janet Wynne, MS|| and
Roger M. Mills, MD, FACC||
* Veterans Administration, San Diego, California
University of California, San Diego, California
The Cleveland Clinic, Cleveland, Ohio
Virginia Commonwealth University Medical Center, Medical College of Virginia, Richmond, Virginia
¶ University of California, Los Angeles, Los Angeles, California
|| Scios Inc., Mountain View, California.
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Figure 1 Time to iBNP Versus Time to Treatment
The relationship between median time to iBNP drawn by quartiles and median time to initial intravenous diuretic treatment is shown. iBNP = immunoreactive B-type natriuretic peptide; IV = intravenous.
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Figure 2 Time to iBNP Versus Time to Treatment by iBNP Quartile
The plot shows the relationship between mean time to iBNP level being drawn and time to initial intravenous diuretic treatment for patients in each iBNP quartile. iBNP = immunoreactive B-type natriuretic peptide; IV = intravenous.
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Figure 3 ED Time Versus Quartiles of Time to Diuretic by iBNP levels
The relationship between time to initial diuretic treatment and total time spent in the emergency department (ED), divided into quartiles, is shown. Each quartile of time to treatment is divided by quartiles of iBNP levels. iBNP = immunoreactive B-type natriuretic peptide; IV = intravenous.
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Figure 4 Patients Asymptomatic at Discharge Versus iBNP Levels
The influence of time to initial treatment on the percentage of patients who are asymptomatic at hospital discharge is shown with time to initial diuretic treatment divided into quartiles. Each quartile of time to treatment is divided by quartiles of iBNP levels. iBNP = immunoreactive B-type natriuretic peptide; IV = intravenous.
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Figure 5 Hospital Mortality, Time to Treatment, and iBNP Level
This 3-dimensional plot shows the relationship of hospital mortality (%) to time of initial treatment (quartiles) and initial iBNP levels being drawn (quartiles). iBNP = immunoreactive B-type natriuretic peptide; IV = intravenous.
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