Role of NT-proBNP in Diagnosis and Prognostic Assessment of Heart Failure Patients
Keywords:
Nt-Probnp, Heart Failure, Biomarkers, Diagnosis, Prognosis, Left Ventricular Ejection Fraction, Nyha Functional Class.Abstract
Background: Heart failure (HF) is a major cause of morbidity, hospitalization, and mortality. N-terminal pro-B-type natriuretic peptide (NT-proBNP), released in response to increased myocardial wall stress, has emerged as an important biomarker for the diagnosis and risk stratification of HF. This study evaluated the diagnostic and prognostic role of NT-proBNP in patients with suspected heart failure.
Methods: This prospective observational study included 110 adult patients presenting with clinical features suggestive of HF. Clinical assessment, laboratory investigations, NT-proBNP measurement, and echocardiography were performed. Patients with confirmed HF were followed for 90 days to assess adverse clinical outcomes. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and independent predictors of adverse outcomes were assessed using multivariate logistic regression.
Results: Heart failure was confirmed in 86 (78.2%) patients. Median NT-proBNP was significantly higher in patients with HF than in those without HF [2840 (1450–5870) vs 310 (165–590) pg/mL; p<0.001]. NT-proBNP increased progressively from NYHA class II to IV (p<0.001) and was highest among patients with HFrEF. At a cut-off of ≥900 pg/mL, NT-proBNP demonstrated an AUC of 0.91, sensitivity of 88.4%, specificity of 83.3%, and diagnostic accuracy of 87.3%. During 90-day follow-up, 28 (32.6%) HF patients experienced adverse outcomes. These patients had significantly higher baseline NT-proBNP [6180 vs 2310 pg/mL; p<0.001]. NT-proBNP ≥5000 pg/mL independently predicted adverse outcomes (AOR 3.18; 95% CI: 1.24–8.16; p=0.016).
Conclusion: NT-proBNP showed excellent diagnostic accuracy and significant prognostic value in patients with HF. Higher concentrations were associated with greater clinical severity, reduced LVEF, and adverse short-term outcomes, supporting its role as a useful adjunct in HF diagnosis and risk stratification.
