Role of NT-proBNP in Predicting Short-Term Mortality and Rehospitalisation in Heart Failure

Abstract

Background

Heart failure (HF) is a major cause of morbidity, mortality, and recurrent hospitalization worldwide. Early identification of high-risk patients is essential for optimizing management and improving clinical outcomes. N-terminal pro-B-type natriuretic peptide (NT-proBNP) has emerged as an important biomarker reflecting myocardial wall stress and may provide valuable prognostic information in patients with HF.

Methods

This prospective observational study included 110 consecutive patients admitted with heart failure. Clinical characteristics, laboratory investigations, including admission NT-proBNP levels, and echocardiographic parameters were recorded. Patients were followed for 90 days to assess the occurrence of all-cause mortality and rehospitalization due to worsening heart failure. Receiver operating characteristic (ROC) curve analysis and multivariable logistic regression were performed to evaluate the prognostic value of NT-proBNP.

Results

The mean age of the study population was 64.3 ± 12.1 years, and 61.8% were male. During the 90-day follow-up, 18 patients (16.4%) died and 32 (29.1%) were rehospitalized. Patients with adverse outcomes had significantly higher admission NT-proBNP concentrations than those without events (p < 0.001). NT-proBNP levels were significantly associated with both short-term mortality and rehospitalization. After adjustment for potential confounders, admission NT-proBNP >5000 pg/mL independently predicted the composite endpoint of mortality or rehospitalization (adjusted OR 4.28, 95% CI 1.89–9.71; p < 0.001). Chronic kidney disease, age ≥65 years, and left ventricular ejection fraction <35% were also independent predictors. ROC analysis demonstrated good predictive performance of NT-proBNP, with an area under the curve of 0.84.

Conclusion

Admission NT-proBNP is a strong independent predictor of short-term mortality and rehospitalization in patients hospitalized with heart failure. Incorporating NT-proBNP into routine clinical assessment may improve early risk stratification, facilitate individualized management, and identify patients who may benefit from closer monitoring and intensified follow-up after hospital discharge.