Preliminary Data on the Potential Usefulness of B-type Natriuretic Peptide Levels in Predicting Outcome After Hospital Discharge in Patients With Heart Failure

Am J Med. 2002 Aug 15;113(3):215-9. doi: 10.1016/s0002-9343(02)01184-1.

Abstract

Purpose: Among patients admitted for treatment of heart failure, we aimed to evaluate the value of B-type natriuretic peptide levels in predicting subsequent death or hospital readmission.

Subjects and methods: We observed and followed 50 consecutive patients admitted with decompensated heart failure. B-type natriuretic peptide levels were measured using an immunofluorometric assay at admission and at discharge. We followed patients for 6 months and ascertained readmissions for cardiovascular causes and death.

Results: Forty-three patients were discharged. There were 20 events during follow-up (15 readmissions and 5 deaths). Mean (+/- SD) B-type natriuretic peptide levels decreased during the initial hospitalization, from 619 +/- 491 pg/mL to 328 +/- 314 pg/mL (P <0.001) among patients who were event free during follow-up, whereas declines were less marked among patients with hospital readmission or death (from 779 +/- 608 pg/mL to 643 +/- 465 pg/mL, P = 0.08). Among the 7 patients with in-hospital increases in B-type natriuretic peptide level, 6 had events, compared with 14 of the 36 patients whose levels declined (P = 0.04). An increase in B-type natriuretic peptide levels during hospital stay was associated with an increased event rate (hazard ratio [HR] = 3.3; 95% confidence interval [CI]: 1.3 to 8.8). Patients whose B-type natriuretic peptide level at discharge was above the median (321 pg/mL) had a somewhat higher rate of dying or being readmitted (HR = 2.3; 95% CI: 0.9 to 5.8).

Conclusion: These preliminary results in a small number of patients suggest that changes in B-type natriuretic peptide levels, as well as predischarge levels, are related to hospital readmission and death within 6 months.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Natriuretic Factor / analysis*
  • Biomarkers / analysis
  • Cohort Studies
  • Continuity of Patient Care*
  • Female
  • Heart Failure / blood*
  • Heart Failure / diagnosis
  • Heart Failure / therapy
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • Natriuretic Peptide, Brain
  • Patient Discharge
  • Predictive Value of Tests
  • Probability
  • Prognosis
  • Prospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Statistics, Nonparametric

Substances

  • Biomarkers
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor