Prognostic Value Of The Plasma NT-proBNP And Ghrelin On Outcome For Patients With Heart Failure

ObjectivesTo explore prognostic value of the plasma amino-terminal pro-brain natriuretic peptide(NT-pro BNP) and Ghrelin on outcome for patients with heart failure. MethodsFrom June 2014 to January 2015, a total of 241 patients with acute heart failure were selected from Emergency Department of Fujian Provincial Hospital. The basic data, echocardiography information, the level of plasma NT-pro BNP and Ghrelin, the outcome while discharged were recorded at baseline. Follow-up contact was made by telephone after discharged. The follow-up NT-pro BNP and echocardiography were measured. Survival analysis was performed by Kaplan-Meier survival curve.The COX proportional hazards model was used to calculate the hazard ratio(HR) of each group. Results1. Totally 241 patients with acute heart failure were enrolled at baseline. The median length of follow-up was 151(14, 449) days. The baseline NT-pro BNP level, deaths occurred higher than no deaths(9597.0pg/ml vs 3298.5pg/ml), deaths or heart failure readmission occurred also higher than no deaths or heart failure readmission(8003.0pg/ml vs 3241.0pg/ml)(all P < 0.01). The baseline Ghrelin level, deaths occurred lower than no deaths(7.83ng/ml vs 9.38ng/ml), deaths or heart failure readmission occurred also lower than no deaths or heart failure readmission(8.15ng/ml vs 9.38ng/ml)(all P < 0.01).2. All-cause mortality, death or heart failure readmission rate in the baseline low NT-pro BNP group were 11.6% and 23.1% respectively. The baseline high NT-pro BNP group were 35.8% and 51.7% respectively. There were significantly difference between two groups(all P<0.01). All-cause mortality, death or heart failure readmission rate in the baseline low Ghrelin group were 31.4% and 44.6% respectively. The baseline high Ghrelin group were 15.8% and 30.0% respectively. There were also significantly difference between two groups(all P<0.05). There was no significant difference in heart failure readmission rate between different NT-pro BNP or Ghrelin level(all P>0.05).3. Kaplan-Meier survival curve showed that no deaths, no heart failure readmission and no deaths or heart failure readmission follow-up curve in low NT-pro BNP group were significantly higher than those of high NT-pro BNP group(all P<0.05). No deaths, no deaths or heart failure readmission follow-up curve in low Ghrelin group were significantly lower than those of high Ghrelin group(all P<0.01). No heart failure readmission follow-up curve in low Ghrelin group was also lower than that of high Ghrelin group, but the difference between the two groups was non-significant(P>0.05).4. COX proportional hazards model analysis found that, compared with the NT-pro BNP≤3801.0 pg/ml and Ghrelin>9.19 ng/ml group, the death occurred HR of group which NT-pro BNP>3801.0 pg/ml and Ghrelin≤9.19 ng/ml was 5.346(95%CI: 1.461~19.561, P<0.05), heart failure readmission occurred HR was 2.922(95%CI: 0.746~11.445, P>0.05), death or heart failure events occurred HR was 4.173(95%CI: 1.677~10.385, P<0.01).5. The follow-up NT-pro BNP level was significantly lower in baseline low NT-pro BNP group than in baseline high NT-pro BNP group(661.6pg/ml vs 3956.5pg/ml)(P<0.01). The follow-up NT-pro BNP level was significantly higher in baseline low Ghrelin group than in baseline high Ghrelin group(1764.5pg/ml vs 593.0pg/ml)(P<0.05). The follow-up NT-pro BNP level was highest in NT-pro BNP>3801.0 pg/ml and Ghrelin≤9.19 ng/ml group of 4 groups(P<0.01). ConclusionsIn patients with acute heart failure, plasma NT-pro BNP>3801.0 pg/ml or Ghrelin≤9.19 ng/ml had poor outcome. The combination of NT-pro BNP and Ghrelin may be more valuable.