Key result
Worsening renal function combined with elevated BNP at discharge was associated with a significantly increased risk of 1-year cardiovascular mortality (HR 10.48) compared to patients without either condition.
Why the study?
Few studies have examined the clinical impact of discharge plasma BNP levels combined with worsening renal function on mortality in patients with heart failure.
Does worsening renal function combined with elevated BNP at discharge predict 1-year cardiovascular mortality and HF readmission in patients with acute decompensated heart failure?
Observational (n=301)
No
Does worsening renal function combined with elevated BNP at discharge predict 1-year cardiovascular mortality and HF readmission in patients with acute decompensated heart failure?
Effect estimate: HR 10.48 (95% CI 1.27-225.53)
Absolute Event Rate: 19.2% vs 1%
p-value: p=0.03
The combination of worsening renal function and elevated BNP at discharge identifies acute decompensated heart failure patients at particularly high risk for 1-year cardiovascular mortality and readmission.
There are a few studies about the clinical impacts of plasma B-type natriuretic peptide (BNP) at discharge with the occurrence of worsening renal function (WRF) on mortality in patients with heart failure (HF). We divided total 301 patients with acute decompensated HF into four groups by the median value (278.7 pg/mL) of BNP level at discharge and by the occurrence of WRF. WRF developed in 100 patients (33.2%). Cardiovascular mortality was significantly different between the four groups (P = 0.0002). Patients with WRF and elevated BNP had a higher cardiovascular mortality than patients without WRF and elevated BNP in Cox proportional hazard models (hazard ratio [HR], 10.48; 95% confident interval [95% CI], 1.27-225.53; P = 0.03). Patients with either WRF or elevated BNP did not have an increased risk of cardiovascular mortality compared to patients without WRF and elevated BNP. Regarding HF readmission and cardiovascular mortality, patients with WRF and elevated BNP had the highest risk (HR, 5.17; 95% CI, 2.07-14.30, P = 0.0003) and patients with either WRF or elevated BNP had a higher risk than patients without WRF and elevated BNP. The occurrence of WRF combined with elevated BNP at discharge was associated with increased 1-year cardiovascular mortality and HF readmission.
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Okabe et al. (2020) conducted an observational in Acute decompensated heart failure (n=301). Worsening renal function with elevated BNP at discharge (W+C+) vs. No worsening renal function and low BNP (W-C-) was evaluated on Cardiovascular mortality (HR 10.48, 95% CI 1.27-225.53, p=0.03). Worsening renal function combined with elevated BNP at discharge was associated with a significantly increased risk of 1-year cardiovascular mortality (HR 10.48) compared to patients without either condition.
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