The outcome for patients hospitalized with New York Heart Association (NYHA) Class III and IV heart failure following therapy can be predicted using the clinical status and B-type natriuretic peptide (BNP) serum level. The authors are from the University of California in San Diego.


Adverse outcomes used as endpoints for study:

(1) early readmission after discharge (within 30 days)

(2) death


Assay for B-type natriuretic peptide: Triage B-type natriuretic peptide test (Biosite Diagnostics, Inc.; San Diego, California).



Clinical Status

BNP Level

successful treatment

improvement (to NYHA Class I or II)

decrease (from 800 – 1,100 pg/mL on admission to 500-800 pg/mL)

early readmission

some improvement

essentially unchanged (from 1,200 – 1,800 pg/mL on admission to 1,000 – 2,000 pg/mL)


no or minimal improvement with therapy

increase (from 1,200 – 1,800 pg/mL on admission to 1,600-2,400 pg/mL)

after Figure 1, page 388



• There are several different assays for BNP. If an alternative assay is used, the levels of BNP need to be adjusted.


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