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Published on: June 10, 2025
[Prognostic value of admission B-type natriuretic peptide on outcome for patients with congestive heart failure]
Xin-tao Deng1, Gui-liang Shi, Ru-xing Wang
1Department of Cardiology, Xinghua People's Hospital Affiliated to Yangzhou University, Xinghua 225700, China.
Insights
Admission B-type natriuretic peptide (BNP) levels predict outcomes in congestive heart failure (CHF) patients. Higher BNP levels (>1910 ng/L) indicate a worse prognosis and increased cardiovascular events within two years.
Area of Science:
- Cardiology
- Biomarkers in Heart Failure
- Prognostic Indicators
Context:
- Congestive heart failure (CHF) poses a significant clinical challenge.
- Accurate prognostic markers are crucial for managing CHF patients.
- B-type natriuretic peptide (BNP) is a key biomarker in cardiovascular disease.
Purpose:
- To evaluate the prognostic value of admission B-type natriuretic peptide (BNP) levels in patients with congestive heart failure (CHF).
- To identify independent risk factors for cardiovascular events in CHF patients.
- To establish a predictive threshold for adverse outcomes based on admission BNP levels.
Summary:
- A study of 162 CHF patients found that admission B-type natriuretic peptide (BNP) levels significantly correlate with cardiovascular events and mortality.
- Patients with higher admission BNP levels (>1500 ng/L) exhibited lower left ventricular ejection fraction (LVEF) and higher rates of cardiovascular events and cardiac mortality.
- BNP, LVEF, Tei-index, and beta-blocker use were identified as independent risk factors for cardiovascular events, with a BNP cutoff of 1910 ng/L predicting a 2.17-fold increased risk.
Impact:
- Admission BNP levels serve as a valuable independent prognostic marker for cardiovascular events in CHF patients.
- The findings support the use of BNP as a critical tool for risk stratification and guiding therapeutic decisions in CHF management.
- A validated BNP threshold (1910 ng/L) can aid clinicians in identifying high-risk CHF patients requiring closer monitoring and intervention.
Objective:
To observe the prognostic value of admission B-type natriuretic peptide (BNP) on outcome for patients with congestive heart failure (CHF).
Methods:
Blood BNP levels, routine echocardiography and tissue Doppler image were obtained in 162 CHF patients [95 male, mean age: (71.8±3.7) years] at admission. Patients were divided into high BNP (BNP>1500 ng/L, n=104) and low BNP (BNP≤1500 ng/L, n=58) groups. All patients were followed up for 2 years and clinical characteristics, echocardiography including Doppler image and cardiovascular events results were analyzed. Data were also compared between patients with (n=48) or without (n=107) cardiovascular events.
Results:
Left ventricular ejection fractions (LVEF) was significantly lower [(40.9±5.6)% vs. (44.0±5.9)%, P<0.01] while the total cardiovascular events rate (49.1% vs. 21.0%, P<0.01) and cardiac mortality rate (25.5% vs. 9.0%, P<0.01) were significantly higher in high BNP group than in low BNP group. BNP level at admission in event group was significantly higher than in event-free group [(2875.4±325.7) ng/L vs. (1136.9±298.6) ng/L, P<0.000]. BNP level was positively related to Tei-index (r=0.793, P<0.001) and negatively correlated with LVEF (r=-0.57, P<0.001). Multiple logistic regression analysis demonstrated that BNP, LVEF, Tei-index and β-blocker use were independent risk factors for cardiovascular events. The area under the ROC curve for predicting cardiovascular death within 2 years in event group by BNP was 0.795 (95%CI 0.693-0.935, sensitivity: 72.31% and specificity: 84.62%, cut-off BNP value: 1910 ng/L). The event risk was 2.17 times higher in CHF patients with admission BNP>1910 ng/L compared CHF patients with admission BNP≤1910 ng/L (95%CI: 1.852-2.954, P=0.000).
Conclusion:
Admission BNP level, LVEF, Tei-index and β-blocker use are independent risk factors for cardiovascular events in patients with CHF. Patients with higher admission BNP level (>1910 ng/L) is linked with worse prognosis in this patient cohort.
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