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Blood Protein Test Can Reduce Heart Failure Readmissions

Human heart and arteries (Yale School of Medicine/Wikimedia Commons)

(Yale School of Medicine/Wikimedia Commons)

A study by researchers at Johns Hopkins University in Baltimore, Maryland indicates that a routine test for a protein in blood can reduce the number of hospital readmissions due to congestive heart failure. Their findings appear online in the American Journal of Cardiology (paid subscription required).

Johns Hopkins research fellow Henry Michtalik and colleagues tested heart failure patients on admission and discharge for levels of a protein N-terminal pro-B-type natriuretic peptide (NT-proBNP) that in previous studies has correlated with heart failure symptoms and been associated with an increase in adverse outcomes. Their study covered 241 heart failure patients admitted to Johns Hopkins Hospital between June 2006 and April 2007 who were treated with intravenous diuretics to remove fluid from the body.

Within the first 24 hours, blood was drawn from the patients and tested for NT-proBNP, and patients were treated for their symptoms by their individual doctors. Though the patients’ NT-proBNP levels were tested again at discharge, decisions to discharge the patients were determined by clinical judgment alone and the treating physicians were not aware of the protein’s level at discharge.

Analysis by the Michtalik team showed that patients whose protein levels decreased by less than 50 percent over the course of the several days to a week were 57 percent more likely to be readmitted or die within a year than those whose levels dropped by a greater percentage.

Heart failure occurs when the heart cannot pump enough blood and oxygen to support other organs. Some 5.8 million people in the United States have heart failure, which kills about 300,000 each year, and results in repeat hospitalizations for many patients.

Michtalik says a good next step would be a prospective randomized trial that examines whether hospitalized heart failure patients do better when their doctors work intensively to decrease the heart failure marker over the course of their hospital stays.

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