RETROSPECTIVE LOOK AT CHANGE IN BRAIN NATRIURETIC PEPTIDE VALUES IN AMBULATORY PATIENTS WITH CHRONIC HEART FAILURE
AbstractBackground: There is significant interest in the role of B-type natriuretic peptide (BNP) guidedtherapy for outpatient congestive heart failure (CHF) patients. The objective of this study was tosee if the percentage change in BNP levels can predict CHF hospitalisations or death. Methods:We retrospectively reviewed the records of CHF patients who had BNP levels drawn on two clinicvisits. Patients were divided into two groups, those with a 70% or greater increase in the BNPvalues and those in whom the BNP value either decreased or did not increase by 70%. Primaryoutcome measured was the need for hospitalisation for CHF or death within 6 months of thesecond clinic visit. Results: One hundred and fourteen (114) paired BNP measurements wereincluded in the analysis. Of these, 26 had >70% increase in BNP while 88 did not. Hospitalisationsfor CHF or death at 6 months were significantly higher in the former group than the latter(p=0.04). On multivariate regression analysis significant change in BNP remained a predictor ofadverse outcomes. Conclusions: In stable outpatients with CHF, >70% increase in BNP is anindependent risk factor for CHF hospitalisations or death at 6 months.Keywords: Congestive heart failure, B-type natriuretic peptide, outpatient, hospitalisation
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