Admission NT-proBNP provides stronger prognostic discrimination than the AHEAD score for 1-year mortality in hospitalized acute heart failure: A retrospective cohort study.
DK, N., TT, T., & VS, H. (2026). Admission NT-proBNP provides stronger prognostic discrimination than the AHEAD score for 1-year mortality in hospitalized acute heart failure: A retrospective cohort study.. PloS one. https://doi.org/10.1371/journal.pone.0353113
DK N, TT T, VS H. Admission NT-proBNP provides stronger prognostic discrimination than the AHEAD score for 1-year mortality in hospitalized acute heart failure: A retrospective cohort study.. PloS one. 2026; doi: 10.1371/journal.pone.0353113
DK N, TT T, VS H. Admission NT-proBNP provides stronger prognostic discrimination than the AHEAD score for 1-year mortality in hospitalized acute heart failure: A retrospective cohort study.[J]. PloS one. 2026. DOI: 10.1371/journal.pone.0353113.
@article{dk2026,
author = {Nguyen DK and Tran TT and Hoang VS},
title = {Admission NT-proBNP provides stronger prognostic discrimination than the AHEAD score for 1-year mortality in hospitalized acute heart failure: A retrospective cohort study.},
journal = {PloS one},
year = {2026},
doi = {10.1371/journal.pone.0353113},
note = {PMID: 42384715},
}
TY - JOUR AU - Nguyen DK AU - Tran TT AU - Hoang VS TI - Admission NT-proBNP provides stronger prognostic discrimination than the AHEAD score for 1-year mortality in hospitalized acute heart failure: A retrospective cohort study. T2 - PloS one PY - 2026 DO - 10.1371/journal.pone.0353113 AN - PMID:42384715 ER -
BACKGROUND: Both admission N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the AHEAD score predict prognosis in acute heart failure, but their comparative and complementary value for admission risk stratification remains uncertain. METHODS: We screened 512 consecutive adult hospitalizations for acute heart failure; 478 records had sufficient baseline data, and 430 patients had ascertainable 1-year vital-status follow-up and constituted the analytic cohort. We compared admission NT-proBNP (log-transformed) with the AHEAD score for 1-year all-cause mortality using Cox models, Harrell C-index, apparent calibration, and reclassification (continuous net reclassification improvement [NRI] and integrated discrimination improvement [IDI]). A combined model of both markers and a combined AHEAD x NT-proBNP stratification were also evaluated. RESULTS: During 1 year, 84 deaths (19.5%) occurred. ln(NT-proBNP) was strongly associated with mortality (adjusted HR 2.63, 95% CI 2.05-3.37 per 1-unit increase; approximately HR 1.95 per doubling). AHEAD categories were associated with mortality in univariable analysis (HR 1.95 for score 2 and 3.61 for score ≥ 3 vs 0-1), but were attenuated after adjustment for ln(NT-proBNP) and admission covariates (adjusted HR 1.03 and 1.81). ln(NT-proBNP) showed higher discrimination than AHEAD categories (Harrell C-index 0.758 vs 0.608). The combined model improved discrimination and reclassification compared with AHEAD alone (C-index 0.757; Delta C-index 0.150; continuous NRI 0.840; IDI 0.136), but not compared with ln(NT-proBNP) alone (Delta C-index 0.000). In combined stratification, the highest NT-proBNP tertile (T3; > 6,385 pg/mL) identified high-risk groups regardless of AHEAD category. CONCLUSIONS: In hospitalized acute heart failure, admission NT-proBNP provided stronger prognostic discrimination than AHEAD categories for 1-year mortality in this cohort. AHEAD may still provide complementary clinical context, but adding AHEAD to ln(NT-proBNP) did not materially improve discrimination beyond NT-proBNP alone. External validation is warranted.