Related Experiment Video

Updated: Jul 12, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

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

Fall in readmission rate for heart failure after implementation of B-type natriuretic peptide testing for discharge

Roberto Valle1, Nadia Aspromonte, Emanuele Carbonieri

  • 1Heart Failure Unit, Department of Cardiology, Ospedale Civile, San Donà di Piave, Italy. robertovalle@libero.it

International Journal of Cardiology
|September 7, 2007
PubMed

Insights

Adding B-type natriuretic peptide (BNP) levels to discharge decisions for heart failure patients significantly reduced readmissions by 12% and lowered care costs by 7%. BNP monitoring improves patient outcomes and healthcare efficiency.

Area of Science:

  • Cardiology
  • Biomarkers
  • Health Economics

Background:

  • B-type natriuretic peptide (BNP) is a key prognostic indicator in hospitalized heart failure patients.
  • Decreasing BNP levels correlate with reduced event rates in outpatients managed with neuro-hormone-targeted therapy.
  • Retrospective analysis investigated the impact of pre-discharge BNP on heart failure readmissions and costs.

Purpose of the Study:

  • To evaluate if incorporating pre-discharge BNP levels into discharge decisions reduces heart failure readmission rates.
  • To assess the effect of BNP-guided discharge on healthcare costs associated with heart failure management.

Main Methods:

  • Two groups of consecutive acute heart failure patients were studied.
  • One group (n=149) was discharged based on clinical judgment alone.
  • The second group (n=166) had BNP levels added to the clinical decisional score for discharge.

Main Results:

  • The BNP group showed significantly fewer readmissions (23%) compared to the clinical group (35%) over six months (P=0.02).
  • Discharge BNP ≤250 pg/mL or a >30% reduction predicted a 23% event rate, versus 71% for others (P=0.001).
  • Overall care costs were 7% lower in the BNP group (€2,781 vs €2,978 per patient).

Conclusions:

  • Adding pre-discharge BNP levels to clinical scores may reduce heart failure readmissions.
  • BNP-guided discharge decisions can contribute to lowering healthcare costs in heart failure management.
  • BNP monitoring offers a valuable tool for optimizing heart failure patient care and resource utilization.
Abstract

Related Concept Videos

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...