The predictive value of brain natriuretic peptide for acute decompensated heart failure in rehospitalized elderly patients

Abstract

Objective To evaluate changes in brain natriuretic peptide(BNP)levels in predicting the risk of acute decompensated heart failure(ADHF)in rehospitalized elderly patients. Methods A cohort study was performed in 48 elderly(≥65 years)patients hospitalized for ADHF from June 2015 to June 2016.All patients underwent standard treatment in internal medicine and were followed up for one month after discharge.The study endpoint was rehospitalization for ADHF.According to whether there was an increase in BNP levels in one-month follow-up, participants were divided into two groups: a group with increased BNP(n=20)and a group without increased BNP(n=28). General clinical information, disease history, signs of circulatory congestion, cardiac ultrasound, and BNP levels were collected and compared between the two groups. Results Compared with the group without increased BNP, the group with increased BNP had higher rates of type 2 diabetes, positive hepatojugular reflux, and jugular vein engorgement(χ2=5.749, 7.243, 4.286, respectively, P<0.05 or P<0.01)and lower left ventricular ejection fraction(t=-3.558, P<0.01). BNP increase in the BNP group was higher than in the non-BNP group(394.2±171.3 ng/L vs.94.2±56.3 ng/L, P<0.01). The rehospitalizationrate in the BNP group was significantly higher than in the non-BNP group(55% or 11 patients vs.17.8% or 5 patients, P<0.01). Multivariate Cox regression analysis found that the increase in BNP in the one-month follow-up was correlated with the increase in rehospitalization(HR=4.118, 95%CI: 1.427-11.884, P<0.01). When the absolute value of BNP rose to over 310ng/L, the risk of rehospitalization in ADHF patients increased. Conclusions Increase in BNP one month after discharges is an effective predictor for rehospitalization in elderly patients with ADHF. Key words: Heart Failure; Natriuretic Peptide, Brain; Hospitalization