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Peptide Level Points to Future Decompensated Heart Failure

Even in stable patients, B-type natriuretic peptide predicts long-term risk of problems

TUESDAY, June 10 (HealthDay News) -- B-type natriuretic peptide (BNP) assessment six months after hospital discharge for decompensated heart failure identifies a long-term risk of future decompensation even in low-risk individuals with non-ischemic dilated cardiomyopathy, according to research published in the June 17 issue of the Journal of the American College of Cardiology.

Mototsugu Nishii, Ph.D., M.D., of the Kitasato University School of Medicine in Sagamihara, Japan, and colleagues analyzed data from 83 patients with non-ischemic dilated cardiomyopathy who were clinically stable for six months after being discharged with decompensated heart failure. BNP was measured every three months from discharge to enrollment, and patients were followed for 18 months after enrollment. The main endpoint was sudden death or first readmission for decompensated heart failure.

The researchers report that 28 patients reached the outcome of interest at a median 11 months after discharge. In multivariate analyses, BNP greater than 190 pg/mL six months after discharge was a significant predictor of a combined event, with a 96 percent sensitivity and 76 percent specificity.

"Now that we can identify patients at increased risk across a wide spectrum of cardiovascular disease, can we intervene with drugs, devices or improved care strategies, or all of these, to effectively change the dismal natural history of the heart failure syndrome? With a better understanding of immunoreactive BNP, we have a new tool in hand to plan better heart failure treatment trials; the challenge now is to skillfully execute them," writes Roger M. Mills, M.D., of Scios, Inc. in Mountain View, Calif., in an accompanying editorial.

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