title: The use of discharge haemoglobin and NT-proBNP to improve short and long-term outcome prediction in patients with acute heart failure.
abstract: OBJECTIVE
  To examine the prognostic value of admission (A) and discharge (D) haemoglobin (Hb) and its relationship with N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) in patients hospitalised for acute heart failure (AHF). The outcomes of interests were rehospitalisation or death after one, six or twelve months after discharge.
  
  
  METHODS
  317 hospitalised AHF patients (74.7±9.4 years) were enrolled in two academic centres in Belgrade and Rome. Laboratory analyses, including NT-proBNP were assessed at admission, and Hb also at discharge. Patients were divided into two groups according to the presence of anaemia. Follow-up contact was made by telephone. Statistical analyses were performed using SPSS software version 21.0.
  
  
  RESULTS
  According to A and DHb levels (<120 g/l for women and <130 g/l for men), anaemia was present in 55% and 62% of patients, respectively ( P=0.497). Lower DHb was associated with the rehospitalisation risk after one (OR=0.96, P=0.004), six (OR=0.97, P<0.001) and 12 months (OR=0.97, P<0.001). For every g/l decrease of DHb, the risk of rehospitalisation after one year was increased by 3.3%. In the first six months, DHb contributed to increased risk of death (OR=0.97, P=0.005), but NT-proBNP showed greater power (OR=2.1, P<0.001).
  
  
  CONCLUSIONS
  In AHF patients discharge anaemia is a strong predictor for short and long-term rehospitalisation, while NT-proBNP seems to be a better predictor for mortality. Discharge Hb and NT-proBNP should be assessed together in order to detect the patients with higher risk of future death and rehospitalisation.
authors.affiliation: 1 Cardiology Department, University Clinical Hospital Center "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Stojcevski
authors.affiliation: 2 Cardiology Department, University Clinical Hospital Center "Dr Dragisa Misovic- Dedinje", Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
authors.affiliation: 3 Department of Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Navarin
authors.affiliation: 2 Cardiology Department, University Clinical Hospital Center "Dr Dragisa Misovic- Dedinje", Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Pencic
authors.affiliation: 1 Cardiology Department, University Clinical Hospital Center "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia.
authors.forename: Anka
authors.initials: A
authors.lastname: Majstorovic
authors.affiliation: 1 Cardiology Department, University Clinical Hospital Center "Dr Dragisa Misovic-Dedinje", Belgrade, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sljivic
authors.affiliation: 4 Emergency Department, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Magrini
authors.affiliation: 3 Department of Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Cristofano
authors.affiliation: 3 Department of Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Lavinia
authors.initials: L
authors.lastname: Cavalieri
authors.affiliation: 3 Department of Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.|4 Emergency Department, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Somma
mesh_terms: D000208:Acute Disease; D000368:Aged; D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death / Q000639:trends; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000401:mortality; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010351:Patient Discharge / Q000639:trends; D010359:Patient Readmission / Q000639:trends; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011498:Protein Precursors; D012372:ROC Curve; D018570:Risk Assessment; D055771:Serbia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Acute heart failure; NT-proBNP; anaemia; haemoglobin; prognosis