Changes in BNP levels from discharge to 6-month visit predict subsequent outcomes in patients with acute heart failure

PLoS One. 2022 Jan 28;17(1):e0263165. doi: 10.1371/journal.pone.0263165. eCollection 2022.

Abstract

Background: This study aimed to investigate the association between changes in brain natriuretic peptide (BNP) from discharge to 6-month visit and subsequent clinical outcomes in patients with acute heart failure (AHF).

Methods: Among 1246 patients enrolled in the prospective longitudinal follow-up study nested from the Kyoto Congestive Heart Failure registry, this study population included 446 patients with available paired BNP data at discharge and 6-month index visit. This study population was classified into 3 groups by percent change in BNP from discharge to 6-month visit; the low tertile (≤-44%, N = 149), the middle tertile (>-44% and ≤22%, N = 149) and the high tertile (>22%, N = 148).

Findings: The cumulative 180-day incidence after the index visit of the primary outcome measure (a composite endpoint of all-cause death or hospitalization for HF) was significantly higher in the high and middle tertiles than in the low tertile (26.8% and 14.4% versus 6.9%, log-rank P<0.0001). The adjusted excess risk of the high tertile relative to the low tertile remained significant for the primary outcome measure (hazard ratio: 3.43, 95% confidence interval: 1.51-8.46, P = 0.003).

Conclusions: Percent change in BNP was associated with a subsequent risk for a composite of all-cause death and hospitalization for HF after adjustment of the absolute BNP values, suggesting that observing the change in BNP levels, in addition to absolute BNP levels themselves, helps us to manage patient with HF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Electrocardiography
  • Female
  • Heart Failure / blood*
  • Heart Failure / diagnostic imaging
  • Heart Failure / drug therapy
  • Hospitalization
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Outcome Assessment, Health Care*
  • Patient Discharge*

Substances

  • Natriuretic Peptide, Brain

Grants and funding

This work was supported by the Japan Agency for Medical Research and Development [18059186] (T.K, K.K, and N.O). https://www.amed.go.jp/en/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.