N-terminal pro b-type natriuretic peptide (NT-pro-BNP) –based score can predict in-hospital mortality in patients with heart failure

Abstract

Serum N-terminal pro b-type natriuretic peptide (NT-pro-BNP) testing is recommended in the patients with heart failure (HF). We hypothesized that NT-pro-BNP, in combination with other clinical factors in terms of a novel NT-pro BNP-based score, may provide even better predictive power for in-hospital mortality among patients with HF. A retrospective study enrolled adult patients with hospitalization-requiring HF who fulfilled the predefined criteria during the period from January 2011 to December 2013. We proposed a novel scoring system consisting of several independent predictors including NT-pro-BNP for predicting in-hospital mortality, and then compared the prognosis-predictive power of the novel NT-pro BNP-based score with other prognosis-predictive scores. A total of 269 patients were enrolled in the current study. Factors such as “serum NT-pro-BNP level above 8100 mg/dl,” “age above 79 years,” “without taking angiotensin converting enzyme inhibitors/angiotensin receptor blocker,” “without taking beta-blocker,” “without taking loop diuretics,” “with mechanical ventilator support,” “with non-invasive ventilator support,” “with vasopressors use,” and “experience of cardio-pulmonary resuscitation” were found as independent predictors. A novel NT-pro BNP-based score composed of these risk factors was proposed with excellent predictability for in-hospital mortality. The proposed novel NT-pro BNP-based score was extremely effective in predicting in-hospital mortality in HF patients.

Association of N-terminal pro-brain natriuretic peptide with contrast-induced acute kidney injury and long-term mortality in patients with heart failure and mid-range ejection fraction

“…[33,34] Similarly, our study demonstrated that NT-proBNP ≥3299 pg/mL is associated with long-term mortality. Therefore, early identification of patients at high risk of CI-AKI and long-term mortality by NT-proBNP may assist in directing treatment and resource use where it will be of greatest benefit.…”

In-hospital mortality is associated with high NT-proBNP level

“…In patients with HF or other heart diseases, NT-proBNP levels ≥6096 ng/L were also associated with higher mortality and prolonged length of stay, although some associations were not statistically significant. These findings are in agreement with the literature [ 18 , 25 , 28 ], and the lack of statistical significance might due to the relatively small number of patients. The same applies for patients with pneumonia, where a significant association was found with prolonged LOS but not with in-hospital mortality.…”

“…Still, these studies also reported that a high NT-proBNP level more than doubled the risk of dying. A Taiwanese single-center study including 269 patients with HF and using a cut-off of 8100 pg/ml reported an Odds-ratio (OR) of 6.65 for in-hospital mortality [ 25 ]. Similarly, an international study including 1256 patients with HF and using a cut-off value of 5180 pg/ml found an OR of 5.2 for 76-day mortality [ 26 ].…”

“…Several studies included NT-proBNP levels in the development of risk scores to predict in-hospital mortality in patients with HF [ 25 , 28 , 29 ] or as a risk stratification tool for acute exacerbations in patients with COPD [ 30 ]. Based on our findings, it is likely that NT-proBNP levels could be used to predict in-hospital mortality in patients with a wider range of pathologies.…”

Left ventricle ejection fraction and strain derived by three-dimensional echocardiography are associated with exercise capacity in the patients with heart failure

“…In our study, the levels of NT-pro BNP were significantly higher in the HF patients with poor prognosis. A wealth of previous studies also reported that the plasma concentrations of NTpro BNP are increased in the patients with HF and accurately predict LVEF as well as morbidity and mortality in these patients [45][46][47] which is in line with our results.…”