Background: Heart Failure (HF) is accompanied by a high cost of care and gloomy prognosis
despite recent advances in its management. Therefore, efforts to minimize HF rehospitalizations
is a major focus of several studies.
Methods: We conducted a retrospective cohort study of 140 patients 18 years and above who had
baseline clinical parameters, echocardiography, NT-ProBNP, troponin I and other laboratory parameters
following a 3-year electronic medical record review. Patients with coronary artery disease, preserved
ejection fraction, pulmonary embolism, cancer, and end-stage renal disease were excluded.
Results: Of the 140 patients admitted with HF with reduced Ejection Fraction (HFrEF) secondary to
non-ischemic cardiomyopathy, 15 were re-hospitalized within 30 days of discharge while 42 were rehospitalized
within 6 months after discharge for decompensated HF. Receiver operating characteristic
(ROC) cutoff points were obtained for NT-ProBNP at 5178 pg/ml and serum troponin I at 0.045
ng/ml. After Cox regression analysis, patients with HFrEF who had higher hemoglobin levels had reduced
odds of re-hospitalization (p = 0.007) within 30 days after discharge. NT-ProBNP and troponin
I were independent predictors of re-hospitalization at 6 months after discharge (p = 0.047 and
p = 0.02), respectively, after Cox regression analysis.
Conclusion: Troponin I and NT-ProBNP at admission are the best predictors of re-hospitalization 6
months after discharge among patients with HFrEF. Hemoglobin is the only predictor of 30 -day rehospitalization
among HFrEF patients in this study. High-risk patients may require aggressive therapy
to improve outcomes.