Real-life use of NT ProbNP in the emergency department of a high-complexity hospital in LatinAmerica
A Torres, D Palacios, M P Morales, A Porras, M HousniAbstract
Background
Natriuretic peptides (NPs) play a crucial role in diagnosing, prognosticating, and monitoring heart failure (HF). Elevated NT-proBNP levels have been associated with worse cardiovascular outcomes, higher rehospitalization rates, and increased mortality. However, local real-world data on their use in clinical practice in developing countries remain limited.
Objective
To characterize hospitalized patients with NT-proBNP above normal values and assess their clinical variables, mortality rates, and associated outcomes.
Methods
We conducted a cross-sectional, observational study including approximately 2,000 patients with NT-proBNP >300 pg/mL hospitalized at our Medical Center, between 2022 and 2023. Data was collected from electronic medical records, analyzing demographic, clinical, and laboratory variables. Statistical comparisons were performed using chi-square tests for categorical variables and Mann-Whitney tests for continuous variables. ROC curves were used to assess NT-proBNP’s predictive value for HF.
Results
The study revealed significant associations between NT-proBNP levels and increased hospital readmission rates and mortality. The most frequent underlying conditions included hypertension (HTN) (48.7%), chronic kidney disease (CKD) (32.1%), and atrial fibrillation (AF) (21.5%). Patients with higher NT-proBNP levels (>1000 pg/mL) exhibited an increased likelihood of in-hospital mortality (OR 3.2, 95% CI 1.9-5.3, p<0.001). Patients on guideline-directed medical therapy (GDMT) showed a significant reduction in NT-proBNP levels over time, correlating with improved survival.
Conclusion
NT-proBNP remains a strong biomarker for risk stratification in hospitalized HF patients. Our findings highlight its relevance in clinical decision-making, particularly in resource-limited settings. Further studies are required to optimize its integration into HF management protocols in developing countries.