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Anales de la Facultad de Medicina

Print version ISSN 1025-5583


LEON-CASTILLO, Brunela; MARTINETTI-GORDILLO, Vittorio; ROMANI-ROMANI, Franco  and  ALARCON-SANTOS, Javier. Amino-terminal pro-brain natriuretic peptide and the red cell distribution width as a prognostic factor of severity in patients with acute decompensated heart failure. An. Fac. med. [online]. 2023, vol.84, n.1, pp.36-44.  Epub Feb 03, 2023. ISSN 1025-5583.


The study of predictors of negative outcomes in patients with heart failure has included the combination of natriuretic peptides and red cell distribution width (RDW).


To evaluate the combined use of the amino-terminal pro-brain natriuretic peptide (NT-proBNP) and RDW as a prognostic factor for death from any cause, prolonged hospitalization, and readmission one year after discharge in patients with decompensated acute heart failure (AHF). Methods: We conducted a retrospective observational study. We constructed a combined index = NT-ProBNP x RDW/100. ROC curves were constructed, sensitivity and specificity were estimated based on the cut-off points, and the relative risk was estimated to develop the outcomes studied. We compared the area under curve of combined index versus NT-proBNP and RDW, separately.


We analyzed data from 471 patients. The combined index had its best cut of 927.79 to predict death during the first year of admission. Those with values ≥ 927,79 had a relative risk of 32.7 (95% CI: 4.8 - 222.3). To predict hospitalization ≥ 7 days, the cut-off point was 752.67; those with this value or higher had a relative risk of 22.4 (95% CI: 9.7 - 51.8). To predict readmission one year after discharge, the cutoff was 858.47 and the relative risk was 4.7 (95% CI: 3.3 - 6.8).


The combined index used generate relative risks that show a strong strength of association for death from any cause, hospitalization ≥7 days, and readmissions one year after discharge. However, the superiority to discriminate was inconclusive with respect to the individual components.

Keywords : Heart Failure; Amino-terminal pro-brain natriuretic peptide; Red Cell Distribution Width; Biomarker; Prognosis.

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