Impact of NT-proBNP on prognosis of acute decompensated chronic heart failure versus de novo heart failure

Se Eun Kim, Dong Hyuk Cho, Jung Woo Son, Jang Young Kim, Seok Min Kang, Myeong Chan Cho, Hae Young Lee, Dong Ju Choi, Eun Seok Jeon, Byung Su Yoo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: NT-pro B-type natriuretic peptide (NT-proBNP) is a powerful prognostic factor for acute heart failure. We investigated whether NT-proBNP levels differ based on the type of heart failure present. Methods: Using the Korean Acute Heart Failure Registry, a prospective, multicenter cohort, we categorized patients into two groups: de novo heart failure (DNHF, n = 1617) and acute decompensated chronic heart failure (ADHF, n = 1212). NT-proBNP levels were measured on admission. The primary outcome was all-cause mortality, and the secondary outcomes were re-hospitalization for heart failure and a composite of all-cause mortality or re-hospitalization for heart failure at 90 days and 1 year. Results: NT-proBNP levels were significantly lower in patients with DNHF than in those with ADHF (median 4213 vs. 5523 ng/L, p < 0.001). Compared to patients with DNHF, patients with ADHF had a significantly worse prognosis for 1-year all-cause mortality (adjusted hazard ratio (HR) = 1.46 [95% confidence interval (CI) = 1.07–1.98], p = 0.017). A higher NT-proBNP level was associated with higher 1-year all-cause mortality for both heart failure types (adjusted HR = 2.00, p = 0.002 in ADHF; adjusted HR = 2.41, p = 0.003 in DNHF). However, all-cause mortality risk was always higher in patients with ADHF than in those with DNHF for any given NT-proBNP level. Conclusion: NT-proBNP levels are an important prognostic factor for both DNHF and ADHF. Notably, patients with ADHF had consistently higher risks than those with DNHF with the same NT-proBNP level for 1-year all-cause mortality.

Original languageEnglish
Pages (from-to)163-170
Number of pages8
JournalInternational Journal of Cardiology
Volume363
DOIs
StatePublished - 15 Sep 2022
Externally publishedYes

Keywords

  • Acute decompensated chronic heart failure
  • De novo heart failure
  • NT-proBNP
  • Prognosis

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