Optimal admission NT-proBNP cutoff value for predicting in-hospital mortality in patients with acute heart failure
Keywords:
acute heart failure, NT-proBNP, biomarker, cutoff value, mortality predictionAbstract
Previous research has demonstrated the relationship between NT-proBNP levels and mortality risk in heart failure patients, and optimal cutoff values have been established for mortality prediction. However, these cutoff values vary among different ethnic populations. This single-center study therefore aims to investigate the relationship between admission NT-proBNP levels and the risk of in-hospital mortality, and to determine the optimal cutoff value for predicting mortality among patients with acute heart failure at Nopparat Rajathanee Hospital. This retrospective study was conducted by recording admission NT-proBNP levels and other baseline clinical characteristics from medical records of 88 acute heart failure patients (44 deceased, 44 survived) admitted to Nopparat Rajathanee Hospital. The study results showed that the median NT-proBNP levels in patients who died were significantly higher than those who survived (28,197 and 2,648 pg/mL respectively, p=0.001), and found that elevated NT-proBNP levels were significantly associated with increased risk of mortality (adjusted OR 1.046 [95% CI: 1.016-1.077], p=0.002). The optimal cutoff value of admission NT-proBNP for predicting in-hospital mortality was 9,020 pg/mL (sensitivity 81.8%, specificity 97.7%, negative predictive value 84.3%, and positive predictive value 97.3%) with an overall test accuracy of 89.8%. This study demonstrates that admission NT-proBNP levels are significantly associated with in-hospital mortality risk, and the cutoff value of admission NT-proBNP at 9,020 pg/mL is a reliable and useful parameter for assessing the risk of in-hospital mortality in patients with acute heart failure. However, it should be considered in conjunction with other clinical indicators.
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