Prognostic Significance of Pre-Discharge Plasma BNP among Heart Failure Patients in Ilorin, Nigeria

Although the usefulness of plasma brain natriuretic peptide (BNP) in early diagnosis of heart failure has been extensively studied, its value in predicting outcome of these patients has not been fully determined, particularly among African patients.

This study was aimed to evaluating the prognostic implications of pre-discharge BNP among hospitalized heart failure patients in Nigeria.

One hundred consecutive acutely decompensated heart failure patients managed in our center were recruited into the study. All subjects had clinical and echocardiographic evaluation. All had BNP assayed and were followed-up for six months.

Fifteen patients (out of 91 who completed the study) died at the end of the study, giving a 6-month mortality rate of 16.5%. The mean BNP among non-survivors (655.0 ± 142.3pg/ml) was higher than survivors (409.7±178.2pg/ml) P <0.001. A plasma BNP level >525pg/ml was 87% sensitive and 75% specific for predicting death within 6-months (AUC0.854,95% CI 0.756-0.951, p<0.001). Kaplan-Meier survival curve also showed six-month survival to be significantly reduced in patients discharged with BNP levels >525pg/ml (57.6%) than in those with levels <525pg/ml (98.3%), p<0.001.

Pre-discharge plasma BNP>525pg/ml in heart failure patients is predictive of early death within six months.