The use of discharge haemoglobin and NT-proBNP to improve short and long-term outcome prediction in patients with acute heart failure

Abstract

In AHF patients discharge anaemia is a strong predictor for short and long-term rehospitalisation, while NT-proBNP seems to be a better predictor for mortality. Discharge Hb and NT-proBNP should be assessed together in order to detect the patients with higher risk of future death and rehospitalisation.

Pre-discharge anemia as a predictor of adverse clinical outcomes in patients with acute decompensated heart failure

“…We found that only anemia at discharge increased all-cause mortality; however, neither anemia at admission nor discharge affected the readmission rate due to worsening of ADHF. In contrast with the results of the abovementioned study [6], discharge anemia was not associated with readmission due to ADHF in our study, and this difference in clinical outcome between the two studies may be related to several factors, such as different LVEF or ethnicity of the sample. Because both are small retrospective studies, works with larger, real-world registries or randomized trials are needed to further explore this issue.…”

“…To the best of our knowledge, few studies have evaluated the clinical impact of anemia at different times during hospitalization. Stojcevski et al [6] showed that discharge Hgb was related to re-hospitalization but not mortality in patients with ADHF. Other study reported that a change in the level of Hgb during hospitalization was independently associated with clinical outcomes in ADHF [7].…”

“…Few studies have investigated the associations between clinical outcomes and anemia developing at different times during hospitalization, even though anemia can onset at any time during hospitalization in association with blood loss, infection, impaired renal function, or other causes [5]. Recent studies have suggested that dynamic changes of Hgb levels are associated with future clinical outcomes in patients with ADHF [6-8].…”

A New Scoring System for Predicting Short-term Outcomes in Critically-ill Acute Decompensated Heart Failure

“…A meta-analysis of ADHF patients has con rmed that NT-proBNP is an independent predictor of mortality both in all-cause and cardiovascular death despite different cut points, time intervals and prognostic models [26] . More recently, Biljana Stojcevski et al reported that discharge NT-proBNP should be assessed to detect the AHF patients with higher risk of short-and long-term death [27] . Although current studies employed different cut-off values for NT-proBNP, we used quartiles for multivariate analysis, which showed that only patients with the highest plasma concentration of NT-proBNP was related to poorer in-hospital outcomes scoring 1 point in the new system.…”

Improving long-term outcomes of acute cardiovascular syndromes

“…The causes are diverse including decreased haematopoiesis frequently related to the presence of an impaired renal function, iron deficiency and also haemodilution related to the congestive state. In a retrospective analysis of patients presenting with acute heart failure anaemia was observed both on admission and discharge in 55 to 62% of the patients (1). Discharge anaemia was associated with a marked increased risk for short (30 days) and long-term (6 months and one year) rehospitalisation.…”