Stay Home! Stay Safe! First Post-Discharge Cardiologic Evaluation of Low-Risk-Low-BNP Heart Failure Patients in...

Area of Science:

• Cardiology
• Clinical Medicine
• Biomarkers

Background:

• COVID-19 pandemic disrupted routine outpatient care for heart failure (HF) patients.
• Periodic evaluations are crucial for managing HF and preventing adverse events.
• The study investigates the role of brain natriuretic peptide (BNP) in predicting outcomes for HF patients with low BNP levels.

Purpose of the Study:

• To assess the predictive value of low brain natriuretic peptide (BNP) levels (<250 pg/mL) for adverse events in heart failure (HF) patients.
• To determine implications for the safe deferral of outpatient follow-up visits.
• To identify independent predictors of adverse events in this patient cohort.

Main Methods:

• Retrospective study including 1000 HF patients with discharge BNP <250 pg/mL.
• Six-month follow-up to record a composite endpoint of death and HF readmission.
• Cox regression analysis (univariate and multivariate) to identify predictors of adverse events.

Main Results:

• 10.4% of patients experienced adverse events (HF readmission or all-cause death) within 6 months.
• Independent predictors of adverse events included BNP levels, serum creatinine, and age.
• Patients with BNP >100 pg/mL and creatinine >1.0 mg/dL had significantly higher event rates (19.0%) compared to those with lower values (4.3%).

Conclusions:

• Low pre-discharge BNP levels (<250 pg/mL) are associated with a low incidence of cardiovascular events in HF patients.
• BNP levels, along with creatinine and age, are independent predictors of adverse outcomes.
• Findings suggest that HF patients with low BNP may tolerate delayed outpatient follow-up, optimizing resource allocation.