High Pro-BNP values indicate mortality in acute heart failure cases: PGI study

Tribune News Service

Naina Mishra

Chandigarh, November 26

A study conducted at the PGI here has unveiled crucial insights into acute heart failure, shedding light on the correlation between Pro-BNP values and mortality.

This was a prospective observational cross-sectional study conducted in the emergency department and emergency medical ward of the PGI. Around 200 adult patients, who were brought to medical emergency from August 1, 2021, to February 28, 2022, were enrolled in this study. The primary focus of the study was to examine the correlation between Pro-BNP values and mortality in acute heart failure patients. Pro-BNP, a marker indicating cardiac stress, was found to have a significant association with mortality. Notably, patients with very high Pro-BNP levels (=2000 pg/ml) exhibited a substantially higher mortality rate compared to those with moderately elevated levels.

When the heart is under stress, as in the case of heart failure, the levels of Pro-BNP and BNP rise. Testing for Pro-BNP or BNP levels in the blood can aid in the diagnosis and management of heart failure. Higher levels of these peptides indicate a greater degree of heart strain.

The secondary objective delved into understanding the prevalence of various precipitating factors for hospitalisation with acute heart failure in the North Indian population and their clinical impact on mortality.

The study identified diabetes as the most prevalent comorbidity, present in 76% of patients. Poorly controlled glycemic status was observed in the majority of patients. Alarmingly, patients with diabetes faced significantly higher mortality (8.5%) compared to non-diabetic patients (2.5%).

Anaemia was noted as a precipitating factor in 7.5% of patients, while sepsis, defined by specific parameters, was present in 41%. Sepsis emerged as a major contributor to acute heart failure, with higher mortality rates associated with this precipitating factor.

Poor compliance with medical treatment was the most frequent precipitating factor, affecting 75.5% of patients. Interestingly, poor compliance did not significantly impact mortality rates compared to patients with good compliance.

The study highlighted that Pro-BNP values, in conjunction with precipitating factors, play a pivotal role in predicting mortality in acute heart failure cases.

The mean age of patients in the North Indian study was notably lower (57.745) than 70 ± 10 observed a similar study conducted in Israel. It indicates that Indian patients may develop acute heart failure approximately one decade earlier than their Western counterparts.

The findings underscore the importance of early identification of high-risk patients.

Early identification important

• Pro-BNP, a marker of cardiac stress, showed a significant association with mortality
• Mortality significantly higher (8.5%) in diabetic patients compared to non-diabetic patients (2.5%)
• Anaemia noted in 7.5% of patients; sepsis in 41% cases emerged as a major precipitating factor
• Poor medical compliance (75.5%) did not significantly affect mortality
• Early identification, Pro-BNP monitoring and addressing precipitating factors can improve outcomes

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