Plasma brain natriuretic peptide — an independent predictor of cardiovascular mortality in acute heart failure

Abstract

Purpose: To examine the prognostic importance of both plasma atrial natriuretic and B-(brain natriuretic peptide) following an episode of acute heart failure. Subjects and methods: A prospective cohort of 91 patients admitted into hospital with acute heart failure were recruited. After initial in-hospital management plasma ANP and BNP levels were measured by radioimmunoassay, and echocardiography was performed on the same day. Patients were followed up for 12 months and the main outcome measure was cardiovascular death. Results: Plasma ANP and BNP levels were significantly higher in patients who died of a cardiovascular cause within 12 months (P < 0.001 and P < (1.0001, respectively) or at I-month (P < 0.05 and P < 0.001) after recruitment. By Kaplan-Meier estimated life-table curves, patients with above median plasma ANP or BNP levels had significantly higher I-year mortality (42.5% vs. 11.6%, both P < 0.005). By multivariate Cox proportional hazard regression analysis, the plasma BNP level was the most important prognostic factor predicting mortality (X 2 = 18.3, P < 0.0001), followed by age (X2 = 11.5, P < 0.001). Other factors mcluding ANP, left ventricular ejection fraction by M-mode echocardiography, pulmonary arterial pressure, sex, cause of heart failure as well as New York Heart Association class were not significant. Conclusion: A plasma BNP level has independent and at least short-term prognostic significance in patients admitted with acute heart failure. This non-invasive and readily available blood test should be considered for risk stratification in patients with acute heart failure.

N‐terminal pro‐B‐type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure

“…This finding is in line with an earlier report in acute HF patients, in which levels of BNP measured at admission were found to hold equal predictive value for in‐hospital mortality and length of stay 12. Additionally, several key studies have evaluated the predictive value of BNP in Asian populations and showed that BNP is a key predictor of outcomes in these patients 30, 31, 32. Also, NT‐proBNP levels had equal predictive value in both HFpEF and HFrEF.…”

N-Terminal Pro-Brain Natriuretic Peptide

“…In addition, elevated BNP and NT-pro-BNP may result directly from cardiac ischemia (8). There is ample evidence that BNP and NT-pro-BNP are useful in diagnosing heart failure (9 -12) and predict prognosis in heart failure (13)(14)(15)(16). BNP guidance in treating heart failure also has been shown to reduce subsequent cardiovascular events in hospitalized heart failure patients (17).…”

Profiling B-type natriuretic peptide in a stable heart failure population: a valuable adjunct to care

“…BNP has been shown to be a predictor of all-cause death [8,9,22] cardiac death [4,23] and sudden cardiac death [24,25] in a number of studies of patients with HF and left ventricular systolic dysfunction in both a hospitalised and an outpatient setting. BNP has also been shown to be a predictor of cardiovascular events [2,5,7,9,26,27] with a few studies showing BNP to be predictive of HF readmissions [2,28].…”

“…Among its uses is the provision of independent prognostic information above and beyond standard parameters. In patients hospitalized with acute decompensated HF, failure to reduce BNP or an increase in BNP during hospital admission is a predictor of death and readmission [2][3][4][5][6]. In non-hospitalised individuals and stable HF patients, a number of studies have evaluated the prognostic information of natriuretic peptides in clinical trial populations [5][6][7][8][9].…”