Plasma N-terminal atrial natriuretic peptide predicts hospitalization in patients with heart failure

The plasma concentration of N-terminal atrial natriuretic peptide (N-ANP) h as been shown to be predictive of both clinical status and survival in pati ents with heart failure. In this analysis the relationship between N-ANP, m orbidity and hospitalization time was evaluated in 417 patients with stable , congestive heart Failure recruited from an active, outpatient heart failu re registry. Hospital admissions along with the duration of stay occurring after the initial N-ANP sampling during the period of data collection were recorded. A total of 755 admissions occurred, accounting for 7917 days' hos pitalization. Relative hospitalization times (in-hospital days/observation period) per N-ANP quartiles I-IV were: 1.2 (+/-2.7)%, 5.5 (+/-12.2)%, 10.0 (+/-21.5)% and 10.8 (+/-34.3)%, respectively. Although N-ANP levels were co rrelated with age (r = 0.234, p < 0.0001), division by age quartiles did no t significantly predict relative hospitalization times. These data indicate that the degree of cardiac endocrine activation and subsequent N-ANP relea se is related to morbidity in patients with heart failure and that moderate elevation in N-ANP levels is associated with a substantially increased hos pitalization time. N-ANP sampling should be of value as a supplement to cli nical evaluation in the assessment of the individual patient with this comm on syndrome.