Abstract 2952: Utility of NT-proBNP and B-Type Natriuretic Peptide in Predicting 90 day Mortality of Hospitalized Patients with Congestive Heart Failure
INTRODUCTION: Heart failure is the leading cause of hospital admission among patients over the age of 65 years. We evaluated the utility of NT-proBNP and B-Type Natriuretic Peptide (BNP) in predicting outcomes of patients admitted with decompensated heart failure (CHF).
METHODS: NT-proBNP (Roche Diagnostics) and BNP (Bayer Healthcare LLC) levels were measured in 171 patients admitted for CHF. Blood samples were taken for the first five days of the admission and again at discharge. Other clinical laboratory values collected during admissions were also recorded. Patients were followed for 90 days from the date of their admission.
RESULTS: Of 171 patients admitted with CHF, there were 25 deaths either during the admission or the 90 day follow up period. The ROC analyses for admission and discharge NT-proBNP and BNP, as well as BUN levels were significant in predicting death in the hospital and within 90 days of discharge. The area under the curve (AUC) for discharge NT-proBNP was 0.846, 0.732, for discharge BNP, and 0.798 for BUN. High plasma BUN levels increased the prognostic ability of NT-proBNP and BNP for death in the hospital and within 90 days. The AUC using NT-proBNP and BUN was 0.864, p < 0.001 with a 95% CI of 0.792– 0.935. The AUC for predicting death within 90 days using discharge BNP and BUN combined was 0.808, p < 0.001 with a 95% CI of 0.717– 0.898. Changes in NT-proBNP and BNP levels between admission and discharge were not significant for predicting death within 90 days.
CONCLUSIONS: Discharge NT-proBNP and BNP levels, together with BUN levels measured during hospitalizations are more useful in predicting death than the changes in NT-proBNP and BNP levels while in the hospital.