Prognostic value of biomarkers and co-morbidities in patients with acute heart failure - A one-year follow-up study

Introduction/Objective Clinical risk stratification of patients hospitalized due to acute heart failure (AHF) applying B-type natriuretic peptide (BNP), troponin I (TnI), and high-sensitivity C-reactive protein (hsCRP) biochemical markers can contribute to early diagnosis of AHF and lower mortality rates. The aim of this study was to investigate the prognostic significance of biomarkers (BNP, TnI, and hsCRP) and co-morbidities concerning one-year mortality in patients with AHF. Methods Clinical group comprised 124 consecutive unselected patients, age 60-80 years, treated at the Coronary Care Unit of the Niska Banja Institute, Nis. The patients were monitored for one year after the discharge. During the first 24 hours after admission, BNP, TnI, and hsCRP were measured in fasting serum. Results Total one-year mortality was 29.8%. The levels of serum BNP were significantly higher in the group of non-survivors compared to the group of survivors (1353.8 +/- 507.8 vs. 718.4 +/- 387.6 pg/mL, p < 0.001). We identified several clinical and biochemical prognostic risk factors by univariate and multivariate analysis. Independent predictors of one-year mortality were the following: BNP, TnI, depression, hypotension, chronic renal failure, ejection fraction, and right-ventricle systolic pressure. Conclusion The presence of BNP and TnI biomarkers and several co-morbidities such as depression or chronic renal failure have significant influence on one-year mortality in patients with AHF.