An NT-ProBNP reduction percentage of less than 30% during hospitalization for acute heart failure predicted 6-month death or readmission (AUC 0.63; 95% CI 0.51-0.75; P=0.04).
Cohort (n=120)
Does NT-ProBNP reduction percentage during hospitalization predict death or readmission in patients with acute heart failure?
A reduction of NT-ProBNP by less than 30% during hospitalization for acute heart failure is a significant predictor of 6-month mortality and readmission.
Effect estimate: AUC 0.63 (95% CI 0.51-0.75)
p-value: p=0.04
We prospectively evaluated whether the N-terminal brain natriuretic peptide (NT-ProBNP) reduction percentage, during hospitalization for acutely decompensated heart failure (HF), has a prognostic significance in 6-month follow-up. In 120 patients consecutively admitted for acute HF to an internal medicine unit, plasma NT-ProBNP was measured on admission and at discharge. During a 6-month follow-up 52 (43.3%) patients had events: 9 (7.5%) died from cardiovascular causes, and 43 (35.8%) were readmitted for HF. In patients without events, the mean reduction percentage of NT-ProBNP was greater than in patients with events (39.5 +/- 7.4 versus 26.3 +/- 5.9%; P = 0.04). In receiver operating characteristic curve analysis, the mean area under the curve for NT-ProBNP reduction percentage was 0.63 (95% CI, 0.51-0.75; P = 0.04) for the composite end point (death or readmission), and 0.81 (95% CI, 0.65-0.97, P = 0.01) for cardiovascular mortality. NT-ProBNP reduction percentage less than 30% was the best cut-off for the identification of patients at risk of events. We suggest that in clinical practice the evaluation of change of NT-ProBNP levels during admission is probably more helpful than predischarge NT-ProBNP absolute value.
Verdiani et al. (Tue,) conducted a cohort in acutely decompensated heart failure (n=120). NT-ProBNP reduction percentage was evaluated on composite end point (death or readmission) (AUC 0.63, 95% CI 0.51-0.75, p=0.04). An NT-ProBNP reduction percentage of less than 30% during hospitalization for acute heart failure predicted 6-month death or readmission (AUC 0.63; 95% CI 0.51-0.75; P=0.04).