Pre-discharge B-type natriuretic peptide predicts early recurrence of decompensated heart failure in patients admitted to a general medical unit

Background B-type natriuretic peptide (BNP) represents a promising predictor of early (30 days) re-admission in patients with heart failure (HF) admitted to cardiology units. Whether BNP retains its predictive value in unselected patients admitted to general medical wards is unknown. Methods We determined BNP levels on admission and pre-discharge in 100 consecutive patients (71 male, mean age 78±10 years) admitted to a general medical unit due to decompensated HF. Follow-up after discharge was 30 days. Results Of the 100 patients, 86 had ≥1 comorbid conditions. Median BNP was 739 pg/ml on admission (25th–75th percentile 355–1333 pg/ml, respectively), and 414 pg/ml pre-discharge (25th–75th percentile 220–696 pg/ml). Seventeen patients were re-admitted or died within 30 days. Patients with pre-discharge BNP values >75th percentile (696 pg/ml) had greater risk of re-hospitalisation, as compared to values ≤696 pg/ml (56% vs. 4%, respectively; p 75th percentile were associated with a 15.0 independent relative hazard (RH) of early re-admission or death (95% CI 4.2–53.8; p