N-terminal brain natriuretic peptide is predictive of death after cardiac transplantation.

C ardiac transplantation is an important treatment option for those patients with end stage heart failure who have failed to respond to disease modifying treatment. However, cardiac transplantation is not without risk, with the one year mortality around 19%, and identifying patients at the highest risk of death is notoriously difficult. Brain natriuretic peptide (BNP) and the N-terminal portion of pro-brain natriuretic peptide (NT-proBNP) are now well established diagnostic and adverse prognostic markers in all stages of congestive heart failure. Indeed, we have shown that NT-proBNP is predictive of death before cardiac transplantation. Studies have also shown that increasing BNP concentrations precede cardiac allograft rejection and are associated with poor survival late after transplantation. However, the prognostic ability of NT-proBNP immediately after cardiac transplantation has not been evaluated. The goal of this study was therefore to assess the short term prognostic ability of NT-proBNP in patients after cardiac transplantation.