NT-proBNP levels predict mortality in patients with acute decompensated and de novo heart failure: Study
Korea: The levels of NT-pro B-type natriuretic peptide (NT-proBNP) are an important prognostic factor for both de novo heart failure (DNHF) and acute decompensated chronic heart failure (ADHF), says a study published in the International Journal of Cardiology.
Patients with ADHF has consistently higher risks for 1-year all-cause mortality with the same NT-proBNP level compared to those with DNHF, the authors noted.
Previous studies have shown NT-proBNP to be a powerful prognostic factor for acute heart failure. Se-Eun Kim, Yonsei University College of Medicine, Seoul, Republic of Korea, and colleagues aimed to examine whether NT-proBNP levels differ based on the type of heart failure present.
Patients were categorized into two groups DNHF (n = 1617) and ADHF (n=1212) using a prospective, multicenter cohort, the Korean Acute Heart Failure Registry. Measurement of NT-proBNP levels was done on admission. All-cause mortality was the primary outcome and secondary outcomes were re-hospitalization for heart failure and a composite of all-cause mortality or re-hospitalization for heart failure at 90 days and 1 year.
Based on the findings, the researchers reported the following findings:
- NT-proBNP levels were significantly lower in patients with DNHF than in those with ADHF (median 4213 vs. 5523 ng/L).
- Compared to patients with DNHF, patients with ADHF had a significantly worse prognosis for 1-year all-cause mortality (adjusted hazard ratio (HR) = 1.46).
- A higher NT-proBNP level was associated with higher 1-year all-cause mortality for both heart failure types (adjusted HR = 2.00 in ADHF; adjusted HR = 2.41 in DNHF).
- All-cause mortality risk was always higher in patients with ADHF than in those with DNHF for any given NT-proBNP level.
The authors conclude, "NT-proBNP had an important role as a prognostic factor in both DNHF and ADHF. However, as time passed ADHF had poorer outcomes than DNHF." "ADHF patients had higher risks than DNHF patients at any level of NT-proBNP."
Reference:
Kim SE, Cho DH, Son JW, Kim JY, Kang SM, Cho MC, Lee HY, Choi DJ, Jeon ES, Yoo BS. Impact of NT-proBNP on prognosis of acute decompensated chronic heart failure versus de novo heart failure. Int J Cardiol. 2022 Jun 23:S0167-5273(22)01007-5. doi: 10.1016/j.ijcard.2022.06.055. Epub ahead of print. PMID: 35753618.
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