Role of Serial BNP Measurements in Congestive Heart Failure: A Descriptive Pilot Study

1Allegheny General Hospital, Pittsburgh, PA
2Allegheny General Hospital, Pittsburgh, PA
3Allegheny General Hospital, Pittsburgh, PA
4Allegheny General Hospital, Pittsburgh, PA
5Allegheny General Hospital, Pittsburgh, PA

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 50

Background:

Congestive heart failure remains the leading admission diagnosis in patients more than 65 years old. The treatment of these patients varies and dependent on each clinician's experience. Currently, there are not significant data reflecting the value of serial BNP monitoring in hospitalized CHF patients.

Methods:

This study included 24 patients in a prospective descriptive study to evaluate the trend of BNP changes during the patients' hospital stay by measuring BNP values each day of the hospital stay and at discharge. The patients were enrolled in the study if they had an admission diagnosis of decompensated CHF.

Results:

The patient characteristics included: mean age 70 years, BMI 30, admission NYHA class of 3.4, 67% with systolic dysfunction, and a majority with hypertension and coronary heart disease. All patients were discharged home. Over the hospital course mean weight change was 4 pounds, and mean discharge NYHA class was 2.23. Mean length of stay for the study was 4 days. In regards to BNP values during the hospital course, mean admission BNP was 1605 ± 866 pg/mL, mean day 1 BNP was 1087 ± 852, mean day 2 BNP was 656 ± 591, and mean discharge BNP was 767. A 1‐way repeated‐measures ANOVA was performed followed by post hoc analysis. The admit BNP value was significantly different than the day 1, day 2, and discharge BNP values (P < .001). Further, the day 1 and day 2 BNP values were significantly different from one another (P = .03). There was no difference between day 2 BNP and day 3, day 4, and discharge BNPs. There was a 35% decrease in BNP from admission to hospital day 1 and a 19% decrease in BNP from day 1 to day 2. However, there was no further decrease in BNP after hospital day 2 through discharge. Nearly all the change in BNP is seen by hospital day 2, with a 54% decrease in BNP compared with that at admission.

Conclusions:

BNP level in patients admitted with decompensated CHF decreased quickly in the first 2 days of the hospital course. Most of the change in BNP was seen between admission and day 1. There was no further decrease in BNP after hospital day 2. In future studies, it is believed that monitoring BNP levels early in the hospital course may be useful for tailoring therapy or use as a discharge tool. The goal may be to achieve a decrease in BNP levels of approximately 50% compared with admission values.

Author Disclosure:

H. Manyam, none; N. Freyvogel, none; R. Smith, none; S. Bhashyam, none; M. Cratty, none.

To cite this abstract:

Manyam H, Freyvogel N, Smith R, Bhashyam S, Cratty M. Role of Serial BNP Measurements in Congestive Heart Failure: A Descriptive Pilot Study. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 50. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/role-of-serial-bnp-measurements-in-congestive-heart-failure-a-descriptive-pilot-study/. Accessed November 13, 2019.

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