Authors

  1. Dunn, Patrick MS, MBA
  2. Gambetta, Miguel MD

Article Content

Rationale:

There is a wealth of evidence demonstrating the clinical value of B-type Natriuretic Peptide (BNP) in patients with heart failure (HF). Levels of BNP and N-terminal proBNP (NT-proBNP), a biologically inactive molecule, can both be assessed via blood analysis. Previous research has found BNP and NT-proBNP provides comparable diagnostic information in patients with HF.

 

Objectives:

The purpose of the present study is to compare the ability of BNP and NT-proBNP to predict 30-day hospitalization in patients with HF.

 

Methodology:

Three hundred and forty-nine subjects diagnosed with HF were included in this analysis. BNP and NT-proBNP were assessed in a HF clinic on an outpatient basis. Subjects were then tracked for hospitalization secondary to HF within 30 days of BNP/NT-proBNP measurement. Pearson product moment correlation determined the relationship between BNP and NT-proBNP. Receiver operating characteristic (ROC) curve analysis assessed the BNP and NT-proBNP prognostic classification schemes and determined the optimal threshold value. Cox regression analysis determined the hazard ratio for the BNP and NT-proBNP prognostic threshold values. All statistical tests with a p-value <0.05 is considered significant.

 

Results:

Mean BNP and NT-proBNP were 673.3 +/- 1030.2 pg/ml and 6974.0 +/- 17171.2 pg/ml, respectively. The correlation between BNP and NT-proBNP was significant (r = 0.76, P < 0.001). One hundred and ten subjects were hospitalized within 30 days. Receiver operating characteristic curve analysis found the BNP (ROC Area: 0.85, 95% CI: 0.81-0.89, P < 0.001) and NT-proBNP (ROC Area: 0.83, 95% CI: 0.78-0.87, P < 0.001) prognostic classification schemes were both significant. The optimal prognostic threshold value for BNP and NT-proBNP was <=/>484.5 pg/ml (83% sensitivity/ 77% specificity) and <=/>3,452.5 pg/ml (83% sensitivity/ 69% specificity), respectively. The hazard ratio for a BNP >484.5 pg/ml and NT-proBNP >3,452.5 pg/ml was 6.6 (95% CI: 4.2-10.4, P < 0.001) and 4.4 (95% CI: 3.1-7.2, P < 0.001), respectively.

 

Conclusions:

The results of the present study indicate BNP and NT-proBNP have very similar short-term prognostic value in patients with HF. Either measure may provide insight into a patients risk for hospitalization to treat their heart condition.