N-terminal brain natriuretic peptide and subsequent hospital admission for worsening heart failure.

R ecurrent and lengthy hospitalisation is common in patients with heart failure and accounts for much of the treatment cost. This has led to interventions aimed at reducing hospitalisation, but identifying patients at risk of hospitalisation is difficult using traditional risk factors. Evidence accumulates for the value of brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NTproBNP) in the diagnosis and management of heart failure. In addition, one study has compared patients with plasma concentrations of NT-proBNP above and below a median of 825 pg/ml, observing a relative risk for hospitalisation with heart failure of 4.7 (95% confidence interval (CI) 2.2 to 10.3; p , 0.001). Patients in that study had chronic, stable heart failure caused by coronary artery disease (CAD) and were participating in a clinical trial. Trial exclusion criteria included a current New York Heart Association (NYHA) rating of IV. In the present study, we examined a UK population cohort of incident cases of heart failure to assess whether NT-proBNP could identify patients at risk of subsequent hospitalisation.