Relation of Level of B-Type Natriuretic Peptide With Outcomes in Patients With Infective Endocarditis

Elevated B-type natriuretic peptide (BNP) is a marker of poor outcomes in heart failure, acute coronary syndromes, and sepsis. Elevated cardiac troponin I (cTnI) is associated with adverse outcomes in infective endocarditis. It was hypothesized that elevated BNP would be associated with increased rates of morbidity and mortality in patients with infective endocarditis, particularly when combined with elevated cTnI. Consecutively enrolled patients in the International Collaboration on Endocarditis Prospective Cohort Study (ICE-PCS) were evaluated at a single center. The association between elevated BNP and a composite outcome of death, intracardiac abscess, and central nervous system event and the individual components of the composite was determined. Similar analyses were performed in patients who had BNP and cTnI measured. Of 103 patients, 45 had BNP measured for clinical indications. The median BNP level was higher in patients with the composite outcome (1,498 vs 433 pg/ml, p = 0.03) and in those who died (2,150 vs 628 pg/ml, p = 0.04). Elevated BNP was significantly associated with the composite outcome (p