Monaldi Arch Chest Dis: BNP-Guided Therapy Optimizes the Timing of Discharge and the Medium Term Risk Stratification in Patients Admitted for Congestive Heart Failure

Article excerpt

Despite a consistent body of data demonstrating the benefits of drug therapy in HF, persistently high rates of readmission, especially within six months of discharge, continue to be documented. Plasma brain natriuretic peptide (BNP), is correlated with the severity of left ventricular dysfunction and relates to outcome. The aim of the study was to evaluate if plasma levels of BNP would provide an index to guide drug treatment and to predict medium-term prognosis in HF patients after hospital discharge. We evaluated 200 consecutive pts (35-96) years, 49% male versus 51% female hospitalized for HF (DRG 127). Standard echocardiography was performed and left ventricular systolic/diastolic function was assessed; plasma BNP levels were measured on days 1 and after initial treatment. Using a cut-off of 240 pg/ml and/or changes in plasma BNP (days 2-3 after admission), 2 groups were identified: the low BNP group-responders (n = 68, BNP < 240 pg/ml and/or > 29% reduction) and the high BNP group-non responders (n = 132, BNP > 240 pg/ml and/or < 30% reduction). …