Key result
Systolic blood pressure, atrial fibrillation, and pulmonary congestion at admission were significant independent predictors of high BNP levels (≥463 pg/ml) at discharge in CHF patients (p<0.001).
Observational (n=85)
CHF patients with hypotension, atrial fibrillation, and pulmonary congestion at admission are at higher risk of persistently high BNP levels at discharge despite guideline-directed therapy.
AIM: To study differences and prognostic effect of some factors on brain (B-type) natriuretic peptide (BNP) levels at discharge of patients with chronic heart failure (CHF) treated in accord with current treatment guidelines. PATIENTS AND METHODS: Eighty-five consecutive patients hospitalized for CHF were recruited into the study. A standardized study protocol was used for them including collection of blood samples for measurement of electrolytes, creatinine at baseline and BNP at discharge. High BNP levels were determined at values above the threshold value for the highest BNP quartile (> or = 463 pg/ml). Linear regression analyses were performed using the SPSS 16.0. RESULTS: High BNP levels at discharge were measured in 21 (24.7%) of the patients. Patients with persisting high BNP levels, despite the administered correct therapy, had significantly more frequently worse clinical and instrumental characteristics: pulmonary congestion (76.2% vs. 40.6%), IV NYHA functional class (23.8% vs. 4.7%), atrial fibrillation (AF) (71.4% vs. 35.9%) and ischemic etiology of HF (47.6% vs. 15.6%). Multivariate linear regression analysis (F = 7.1, p < 0.001) identified systolic blood pressure (SBP), AF and instrumental data for pulmonary congestion as significant and independent predictors of high BNP at discharge. CONCLUSIONS: There were statistically significant differences in the distribution and prognostic effect of the studied factors across the BNP levels. CHF patients with hypotension, AF and instrumental evidence for pulmonary congestion at admission are at higher risk of high BNP levels at discharge and require special care and clinical approach.
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Vitlianova et al. (2011) conducted an observational in chronic heart failure (CHF) (n=85). Clinical factors (systolic blood pressure, atrial fibrillation, pulmonary congestion) was evaluated on High BNP levels at discharge (≥ 463 pg/ml) (p=< 0.001). Systolic blood pressure, atrial fibrillation, and pulmonary congestion at admission were significant independent predictors of high BNP levels (≥463 pg/ml) at discharge in CHF patients (p<0.001).
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