Page 109 - Biomarkers for risk stratification and guidance in heart failure

Chapter 5
angiotensin-converting enzyme; ARB, angiotensin receptor blocker. Values are expressed as n (%), mean (SD), or median (interquartile range).
Prediction of Outcome
Median time from hospital discharge to the outpatient visit 1 month after discharge was 30 days (IQR 27-36 days), with a median follow-up duration of 675 days (IQR 472-700 days) after this visit.
Within the follow-up period, 83 patients died (26.9%) and 131 patients reached the combined end point of HF readmission or mortality (42.4%). Both mortality and the combined end point at 90, 180, and 365 days in the overall population are presented in Table 2. In univariate Cox regression analyses, all NT-proBNP parameters except NT-proBNP concentration at admission were highly associated with mortality (Table 3).
Comparison With Patients Not Included in This Analysis
In 309 of 345 patients, NT-proBNP concentration 1 month after hospital discharge was available. Of the patients not included for the present analysis, 5 died within 30 days after hospital discharge and 6 had reached the combined end point of HF-related readmission or mortality. After exclusion of these patients, there was a trend toward increased mortality in patients with no NT-proBNP concentration available 1 month after hospital discharge compared to those with NT-proBNP concentration available (HR 1.75, 95% CI 0.96-3.21; P=.070). However, no difference was seen in combined end point (HR 1.14, 95% CI 0.66-1.97; P= .65).
Correlation Among NT-proBNP Parameters
Correlations among NT-proBNP parameters are depicted in Supplemental Table 1. No correlation existed between inpatient change in NT-proBNP concentration and early outpatient change (r=-0.01; P= .815). Modest correlations existed between NT- proBNP concentration 1 month after hospital discharge and both inpatient and early outpatient change in NT-proBNP concentration, with strongest correlation being present between inpatient change and NT-proBNP concentration at 1 month follow-up (r= 0.56; P < .001). However, we found strong correlations between the absolute NT-proBNP concentration at admission, discharge, and 1 month after hospital discharge, with strongest correlation between NT-proBNP at admission and at discharge (r = 0.79; P < .0001).
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