N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients

• Type: Article in International Scientific Journal
• Date: 2004

Authors

Bettencourt P (Author) FMUP; Azevedo A (Author) FMUP; Pimenta J (Author) FMUP; Friões F (Author) FMUP; Ferreira, S (Author) Other; Ferreira A (Author) FMUP

Journal

Title: Circulation

Vol. 110

Pages: 2168-2174

ISSN: 0009-7322

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 539 Citations

Scopus - 604 Citations

Scientific classification

FOS: Natural sciences

Other information

Authenticus ID: P-000-844

DOI: 10.1161/01.cir.0000144310.04433.be

Abstract (EN): Background-Heart failure (HF) is responsible for a huge burden in hospital care. Our goal was to evaluate the value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) in predicting death or hospital readmission after discharge of HF patients. Methods and Results-We included 182 patients consecutively admitted to hospital because of decompensated HF. Patients were followed up for 6 months. The primary end point was death or readmission. Twenty-six patients died in hospital. The median admission NT-proBNP level was 6778.5 pg/mL, and the median level at discharge was 4137.0 pg/mL (P < 0.001). Patients were classified into 3 groups: (1) decreasing NT-proBNP levels by at least 30% (n = 82), (2) no significant modifications on NT-proBNP levels (n = 49), and (3) increasing NT-proBNP levels by at least 30% (n = 25). The primary end point was observed in 42.9% patients. Variables associated with an increased hazard of death and/or hospital readmission in univariate analysis were length of hospitalization, heart rate, signs of volume overload, no use of ACE inhibitors, higher NYHA class at discharge, admission and discharge NT-proBNP, and the change in NT-proBNP levels. The variation in NT-proBNP was the strongest predictor of an adverse outcome. Independent variables associated with an increased risk of readmission or death were signs of volume overload and the change in NT-proBNP levels. Conclusions-Variations in NT-proBNP levels are related to hospital readmission and death within 6 months. NT-proBNP levels are potentially useful in the evaluation of treatment efficacy and might help clinicians in planning discharge of HF patients. Whether therapeutic strategies aimed to lower NT-proBNP levels modify prognosis warrants future investigation.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7