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Updated: Dec 30, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

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Using BNP to develop a risk score for heart failure in primary care

David Adlam1, Paul Silcocks, Nigel Sparrow

  • 1Department of Cardiovascular Medicine, Queen's Medical Centre, Nottingham, UK. davidadlam@dcotors.org.uk

European Heart Journal
|March 17, 2005
PubMed

Insights

A new scoring system using B-type natriuretic peptide (BNP), age, and clinical factors helps predict mortality in primary care heart failure patients. This tool aids risk stratification beyond single diagnostic values.

Area of Science:

  • Cardiology
  • Primary Care Medicine
  • Biostatistics

Background:

  • Chronic heart failure (CHF) presents a significant mortality risk.
  • Accurate CHF diagnosis in primary care is challenging.
  • Elevated B-type natriuretic peptide (BNP) indicates left ventricular systolic dysfunction and poor prognosis.

Purpose of the Study:

  • Identify independent predictors of mortality in primary care patients on loop diuretics.
  • Develop and validate a prognostic scoring system for heart failure in general practice.

Main Methods:

  • Prospective follow-up of 532 patients for a mean of 6.4 years.
  • Clinical assessment, ECG, echocardiography, and BNP measurements.
  • Multivariate analysis to derive and validate a prognostic score.

Main Results:

  • A prognostic score was generated: [0.50 x BNP + 5 x age + 50 x (CVA + sex + diabetes + ECG)].
  • The score demonstrated good predictive accuracy (Harrell's c=0.75).
  • Defined cut-off scores for risk stratification: 25th percentile (411), 50th (475), and 75th (524).

Conclusions:

  • Prognostic scoring systems enable risk stratification without relying on single BNP cut-offs.
  • Further validation of these scores can enhance the management of community-based heart failure.
Abstract

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