Key result
Elevated NT-proBNP was associated with increased all-cause mortality and was the only biomarker predicting cardiac re-hospitalization.
Why the study?
To assess the predictive role of biomarkers reflecting cardiovascular stress, neuroendocrine response, and renal function regarding mortality and re-hospitalization in patients admitted for HF.
Do cardiovascular biomarkers predict post-discharge re-hospitalization risk and mortality in patients hospitalized for heart failure?
Cohort (n=286)
Do cardiovascular biomarkers predict post-discharge re-hospitalization risk and mortality in patients hospitalized for heart failure?
Multiple biomarkers including MR-proADM, copeptin, and cystatin C predict mortality in heart failure patients post-discharge, but only NT-proBNP significantly predicts cardiac re-hospitalization.
Answers are grounded in this paper and cite their sources.
NT-proBNP may refine post-discharge risk assessment in HF; hypothesis-generating and requires prospective validation before clinical adoption.
Aim The aim of this study was to assess the predictive role of biomarkers, associated with cardiovascular stress and its neuroendocrine response as well as renal function, in relation to mortality and risk of re-hospitalization among consecutive patients admitted because of heart failure (HF). Methods and results A total of 286 patients (mean age, 75 years; 29% women) hospitalized for newly diagnosed or exacerbated HF were analysed. Associations between circulating levels of mid-regional pro-adrenomedullin (MR-proADM), copeptin, C-terminal pro-endothelin-1, N-terminal pro-brain natriuretic peptide (NT-proBNP), cystatin C, and all-cause mortality as well as risk of re-hospitalization due to cardiac causes were assessed using multivariable Cox regression models. A two-sided Bonferroni-corrected P-value of 0.05/5 = 0.010 was considered statistically significant. All biomarkers were related to echocardiographic measurements of cardiac dimensions and function. A total of 57 patients died (median follow-up time, 17 months). In the multivariable-adjusted Cox regression analyses, all biomarkers, except C-terminal pro-endothelin-1, were significantly associated with increased mortality: NT-proBNP [hazard ratio (HR) 1.85, 95% confidence interval (CI) 1.17–2.17; P = 4.0 × 10−4], MR-proADM (HR 1.94, 95% CI 1.36–2.75; P = 2.2 × 10−4), copeptin (HR 1.70, 95% CI 1.22–2.36; P = 0.002), and cystatin C (HR 2.11, 95% CI 1.56–2.86; P = 1.0 × 10−6). A total of 90 patients were re-hospitalized (median time to re-hospitalization, 5 months). In multivariable Cox regression analyses, NT-proBNP was the only biomarker that showed significant association with risk of re-hospitalization due to cardiac causes (HR 1.43, 95% CI 1.10–1.87; P = 0.009). Conclusions Among patients hospitalized for HF, elevated plasma levels of NT-proBNP, MR-proADM, copeptin, and cystatin C are associated with higher mortality after discharge, whereas NT-proBNP is the only biomarker that predicts the risk of re-hospitalization due to cardiac causes.
No takes yet. Share an insight, caveat, or question.
Molvin et al. (2019) conducted a cohort in Heart failure (n=286). Cardiovascular biomarkers (NT-proBNP, MR-proADM, copeptin, cystatin C) was evaluated on All-cause mortality (HR 1.85, 95% CI 1.17-2.17, p=4.0 × 10−4). Elevated NT-proBNP was associated with increased all-cause mortality and was the only biomarker predicting cardiac re-hospitalization.
Synapse has enriched 10 related papers. Consider them for comparative context: