Evaluating the Role of Baseline Brain Natriuretic Peptide in Predicting Heart Failure Post-acute Coronary Syndrome: Systematic Review and Meta-analysis.

Abstract

Context: Heart failure (HF) is a frequent complication following acute coronary syndrome (ACS), leading to higher mortality and rehospitalization rates. Measurement of brain natriuretic peptide (BNP) is well established to diagnose HF, and its levels during ACS have been associated with poor outcomes.

Aims: This review aims to assess the predictive value of baseline BNP in determining the risk of HF following ACS.

Methods: The search for relevant studies was conducted through Medline database, focusing on studies that reported baseline BNP values in ACS patients, the incidence of HF after follow-up, and their possible association. Statistical analysis was performed using Review Manager.

Results: Out of 647 studies, 10 met the inclusion criteria. Eight studies showed a positive association between baseline BNP and HF post-ACS. However, the meta-analysis revealed no significant difference in HF occurrence based on baseline BNP levels (odds ratio 1.83, 95% confidence interval [CI]: 0.11-29.07, P = 0.67). Although the development of HF was significantly correlated with higher baseline BNP (standard mean difference: 0.95, 95% CI: 0.54-1.37, P < 0.001).

Conclusions: Elevated baseline BNP levels were associated with an increased likelihood of HF following ACS. However, BNP alone may not be a reliable predictor. Serial measurements and integration with other risk factors may improve its predictive accuracy.