Khanam SS, et al. – In a study population of patients with heart failure (HF), researchers assessed the link between short–term follow–up B-type natriuretic peptide (BNP) and mortality after discharge. Findings demonstrated that short–term follow–up BNP and percent change in BNP level were identified as significant prognostic factors of all–cause mortality in these patients. These values will be clinically useful when evaluating prognosis in hospitalized patients with heart failure.

Methods

• Researchers analyzed 427 patients hospitalized with HF from the Wonju Severance Christian Hospital Heart Failure Registry from April 2011 to December 2013, with a planned follow-up period through February 2016.
• Of the 427 patients, 240 (mean age, 75 years; 102 males, 42.5%) had BNP measured on admission and within the short-term follow-up period (3 months).
• They compared all-cause mortality during the clinical follow-up period (median length of follow-up, 709.5 days) according to the median value of BNP on admission (as a baseline value) and over a short-term follow-up period after discharge.

Results

• Findings reported that median BNP at admission was 816.5 pg/ml, and median follow-up BNP was 369.7 pg/ml.
• Researchers found that multivariate analysis revealed a positive association between risk of death and high BNP.
• They noted that high BNP during follow-up was significantly associated with a greater risk of all-cause mortality compared to low BNP (P < 0.001).
• They also observed that initial BNP was not significantly associated with all-cause mortality.
• Additionally, a multivariate model demonstrated that follow-up BNP and percent change in BNP were independently associated with all-cause mortality after adjustment for covariates.
• According to findings, out of the 3 BNP measurement strategies, BNP after discharge (IDI of 0.072, P < .0001 and NRI of 0.707, P < .0001) and percent change in BNP (IDI of 0.113, P < .0001 and NRI of 0.782, P < .0001) demonstrated the greatest increase in discrimination and net reclassification for mortality.
• Unfortunately, researchers did not find any significant value with initial BNP.
• Moreover, Kaplan-Meier survival analysis was performed to evaluate mortality stratified by BNP according to the median value, high median of follow-up BNP and percent change in BNP were associated with significantly higher mortality compared to the below median (log-rank, p < 0.001).