title: B-type natriuretic peptide predicts benefit from a home-based nurse care in chronic heart failure.
abstract: BACKGROUND
  Home-based nurse care (HBNC) can reduce adverse events in patients with chronic heart failure. However, which patients really benefit from such an intervention remains unclear. We investigated if B-type natriuretic peptide (BNP), a strong prognostic marker in chronic heart failure, can predict benefit from HBNC.
  
  
  RESULTS
  After discharge from heart failure hospitalization, 96 patients were randomized to either HBNC for 12 months or usual care. The combined endpoint of death or heart failure hospitalization was evaluated after 12 and 24 months. The median value of BNP (267 pg/mL) was used as a cutoff value to predict benefit from the HBNC. HBNC reduced the endpoint after 12 (P = .013) and 24 months (P = .033, relative risk [RR] (95% confidence intervals): 0.42 [0.20-0.78] and 0.55 [0.31-0.98], respectively). This benefit from HBNC was dependent on BNP. In patients with supramedian BNP, the endpoint was significantly reduced after 12 (P = .002) and 24 months (P = .003, RR: 0.39 [0.20-0.76] and 0.50 [0.30-0.83], respectively), whereas in patients with inframedian BNP no significant changes occurred.
  
  
  CONCLUSIONS
  A high BNP can predict benefit from HBNC in patients with chronic heart failure and may assist in selecting patients for such an intervention.
authors.affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria. deddo.moertl@meduniwien.ac.at
authors.forename: Deddo
authors.initials: D
authors.lastname: Moertl
authors.forename: Rudolf
authors.initials: R
authors.lastname: Berger
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hammer
authors.forename: Martin
authors.initials: M
authors.lastname: Huelsmann
authors.forename: Raisa
authors.initials: R
authors.lastname: Hutuleac
authors.forename: Richard
authors.initials: R
authors.lastname: Pacher