Exploring the Prospective Insights Into the Prognostics of N-terminal Pro-B-Type Natriuretic Peptide in Predicting Heart Failure Readmissions in a Tertiary Healthcare Setting.

BACKGROUND: Heart failure (HF) is a significant cause of morbidity and hospital readmission despite improvements in treatment. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a sensitive biomarker of ventricular wall stress and could be able to give prognostic insight into the post-discharge outcome. The aim of the study was to evaluate the prognostics of NT-proBNP in predicting heart failure readmissions in a tertiary healthcare setting. METHODS: This prospective observational study involved 200 patients (February 2025 to July 2025) with acute decompensated HF from the Department of Cardiology of Indus Medical College Hospital (IMCH) and Nawaz Sharif Medical College (NSMC), Pakistan. NT-proBNP was analyzed via electrochemiluminescence immunoassay (ECLIA) within 24 hours of discharge. The median NT-proBNP of the cohort was used to stratify the patients. T-tests and chi-square tests were used to compare demographic, clinical, and echocardiographic parameters. Multivariate Cox regression that was adjusted by renal function (eGFR), body mass index (BMI), atrial fibrillation, serum sodium, and congestion indicators was used to identify predictors of six-month readmission. RESULT: NT-proBNP (mean) was measured as 2,410 ± 620 pg/mL and 8,920 ± 1,850 pg/mL in the lower and higher groups, respectively (p < 0.001). In total, readmission rates were 27% and higher in the high NT-proBNP group (40% vs. 14% p < 0.001). The higher group was found to have less left ventricular ejection fraction (LVEF) (38.6 ± 6.9% vs. 42.8 ± 7.2%, p = 0.001). Multivariate analysis established high NT-proBNP as a risk factor of readmission (heart rate (HR) = 2.76; 95% confidence interval (CI): 1.61-4.74; p < 0.001). CONCLUSION: High NT-proBNP levels are a predictor of increased risk of HF readmission in six months. NT-proBNP measurement could help in risk stratification and focused follow-up; however, additional research is required to allow clinically validated cut-off values.