Changes of Natriuretic Peptides Predict Hospital Admissions in Patients With Chronic Heart Failure: A Meta-Analysis

Study Questions:

What is the association between changes in B-type natriuretic peptide (BNP) and/or N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels in predicting hospitalization for worsening heart failure (HF) in patients with chronic systolic HF?


This was a meta-analysis. Included studies had a randomized protocol and evaluated BNP/NT-proBNP levels at baseline and at the end of follow-up. Meta-regression analysis was used to test the relationship between BNP and NT-proBNP changes, and the clinical endpoint of rehospitalization for worsening HF.


Nineteen trials (n = 12,891 participants) were included; median follow-up was 9.5 months. When significant heterogeneity was resolved (by removing one study assessing nonpharmacological therapy), changes in BNP and NT-proBNP were significantly associated with risk of hospital stay for worsening HF (regression coefficient: 0.036; 95% confidence interval, 0.015-0.056; regression p = 0.002; heterogeneity p = 0.056).


The authors concluded that changes in plasma levels of BNP and NT-proBNP predict risk for worsening hospitalization in patients with chronic systolic HF in this meta-analysis.


The limitations of this meta-analysis aside, the authors provide useful evidence about the value of short-term changes of BNP and NT-proBNP being predictive of hospitalization for HF. Future research and studies should help clarify how to routinely incorporate the measurement of changes in these biomarkers into clinical care of patients with chronic HF.

Clinical Topics: Anticoagulation Management, Heart Failure and Cardiomyopathies, Acute Heart Failure, Heart Failure and Cardiac Biomarkers

Keywords: Follow-Up Studies, Heart Failure, Peptide Fragments, Hospitalization, Length of Stay, Natriuretic Peptide, Brain

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