Biomarkers for predicting rehospitalization in acute decompensated heart failure

Acute decompensated heart failure (ADHF) remains a leading cause of hospital admission and is associated with poor clinical outcomes, despite the implementation of guideline-directed medical therapy. This retrospective cohort study aimed to identify laboratory biomarkers predictive of rehospitalization in patients admitted with ADHF to a tertiary cardiac intensive care unit. A total of 100 patients were included and followed for 24 months after discharge in a euvolemic state on optimized heart failure therapy. Laboratory parameters assessed prior to discharge included NT-proBNP, high-sensitivity troponin I (hs-Tn I), hemoglobin, serum sodium, FIB-4 index, and C-reactive protein/albumin ratio. Cox proportional hazards modeling identifi ed several independent predictors of rehospitalization, with NT-proBNP demonstrating the strongest association (HR = 2.000; p = 0.045). Additional signifi cant predictors included elevated hs-TnI, reduced hemoglobin, hyponatremia, and increased FIB-4 index (all p < 0.05). Kaplan-Meier survival analysis revealed the poorest event-free survival among patients with HFrEF. These fi ndings highlight the clinical value of a multiparametric risk assessment approach at discharge, to guide individualized monitoring and therapeutic strategies in patients with ADHF.