Prognostic Utility of N-terminal Pro-B-type Natriuretic Peptide (NT-proBNP) for Predicting Hospital Readmissions in Patients With Heart Failure: A Systematic Review of Clinical Evidence

This systematic review examines the prognostic utility of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for predicting hospital readmissions in patients with heart failure (HF). HF remains a leading cause of recurrent hospitalizations, contributing to increased morbidity and healthcare burden. While NT-proBNP is widely established for diagnosis and mortality prediction in HF, its role in forecasting hospital readmission risk-particularly at varying time frames-remains unclear. A comprehensive search of PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) yielded 452 records, of which six studies met the inclusion criteria. These included one randomized controlled trial, one post hoc RCT analysis, and four observational or registry-based studies. The methodological quality was assessed using RoB 2.0, the NIH Quality Assessment Tool, and the Newcastle-Ottawa Scale, revealing low to moderate risk of bias. The review found that isolated NT-proBNP values at admission showed limited predictive value, while serial measurements during hospitalization or within early post-discharge periods (e.g., 30-180 days) demonstrated stronger associations with readmission risk. Predictive variability was influenced by factors such as timing of measurement, renal function, age, and sex. Comparators, where present, varied across studies and included standard care or alternative biomarkers. Notably, current clinical guidelines lack standardized protocols for using NT-proBNP in readmission risk prediction, leading to inconsistent applications in practice. This review underscores the need for individualized interpretation and standardized measurement strategies to enhance NT-proBNP's utility in discharge planning and post-acute care of patients with HF.