title: [Value of admission NT-proBNP in predicting in-hospital mortality in decompensated systolic heart failure].
abstract: OBJECTIVE
  To evaluate the value of NT-proBNP in predicting in-hospital mortality in patients with decompensated systolic heart failure.
  
  
  METHODS
  Plasma NT-proBNP levels within 24 hours of admission were obtained in 366 patients with decompensated systolic heart failure. The levels were compared between dying patients in hospital and survival patients at discharge. ROC analyses were performed to evaluate if NT-proBNP was a predictor for in-hospital mortality and identify the optimal NT-proBNP cut-off point for predicting in-hospital mortality. A binary logistic regression analysis was used to evaluate if NT-proBNP was an independent predictor for in-hospital mortality.
  
  
  RESULTS
  19 cases of the 366 patients died in hospital. NT-proBNP levels of the dying cases were much higher than those of the survivals 3970 (3452, 6934) pmol/L vs 2340 (1132, 4002) pmol/L respectively, P < 0.01). ROC analysis of NT-proBNP to predict in-hospital mortality had an area under the curve (AUC) of 0.762 (95% CI: 0.657-0.857, P < 0.01), the optimal NT-proBNP cut-off point for predicting in-hospital mortality was 3500 pmol/L with a sensitivity of 73.7%, a specificity of 66.9%, an accuracy of 67.6% and a negative predictive value of 97.9%. Patients whose NT-proBNP levels were equal or more than 3500 pmol/L had an in-hospital mortality of 10.9%, compare with 2.1% in those NT-proBNP levels less than 3500 pmol/L (P < 0.01). Binary logistic regression analysis demonstrated that NT-proBNP was an independent predictor for in-hospital mortality in patients with decompensated systolic heart failure (P < 0.01).
  
  
  CONCLUSIONS
  Admission plasma NT-proBNP level is an independent predictor for in-hospital mortality in patients with decompensated systolic heart failure. The optimal NT-proBNP cut-off point for predicting in-hospital mortality is 3500 pmol/L.
authors: Heart Failure Care Unit, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China.
authors: Bing-Qi
authors: BQ
authors: Wei
authors: Yue-Jin
authors: YJ
authors: Yang
authors: Jian
authors: J
authors: Zhang
authors: Yu-Hui
authors: YH
authors: Zhang
authors: Lian-Ming
authors: LM
authors: Kang
authors: Ke-Fei
authors: KF
authors: Dou
authors: Dong
authors: D
authors: Wang
authors: Rong
authors: R
authors: Lü
authors: Xin
authors: X
authors: Gao
authors: Li-Tian
authors: LT
authors: Yu
authors: Guo-Gan
authors: GG
authors: Wang
authors: Yan-Min
authors: YM
authors: Yang
authors: Hui-Qiong
authors: HQ
authors: Tan
authors: Jun
authors: J
authors: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain