B-type natriuretic peptide as a risk predictor of long-term outcomes in heart failure patients

Background

Hospitalization for decompensated heart failure (DHF) carries a poor prognosis, with frequent readmissions. The B-type natriuretic peptide (BNP) is secreted by an overloaded left ventricle, and the prognostic value of the admission BNP assay has not been established for patients with DHF.

Objective

To determine the prognostic value of admission BNP in patients hospitalized due to DHF.

Methods

We conducted a prospective observational cohort study in 63 consecutive patients admitted to the coronary care unit with DHF between January and December 2003. Clinical features and outcomes were recorded. BNP was measured on admission and correlated with the combined end point of death and readmission for DHF. Patients were followed up for at least 12 months.

Results

Baseline characteristics and main outcomes of this cohort were: 50.8% of patients were male, mean age was 77.3 years and 85.7% of patients were in NYHA class IV. Inhospital mortality was 12.7%. Through ROC curve analyses a BNP cutoff level of 1160 pg/ml was defined, and on Kaplan–Meier curves it turned out to be strongly related to death or readmission (P = 0.0076).

Conclusion

A high admission BNP level is a strong predictor of death or readmission in patients hospitalized for DHF.