Poor Uptake of NT-proBNP and Factors Associated with Elevated Values among Acute Heart Failure Patients in Sub-saharan Africa: a post hoc Analysis of the Douala Heart Failure Registry (Do-HF): Mauvaise absorption du NT-proBNP et facteurs associés à des valeurs élevées chez les patients atteints d’insuffisance cardiaque aiguë en Afrique subsaharienne : une analyse post-hoc du registre d’insuffisance cardiaque de Douala (Do-HF)

Abstract

Introduction. Heart Failure (HF) is a major worldwide public health problem. International HF guidelines recommended using amino-terminal congeners (BNP or NT- proBNP) as the biomarker of choice for management of HF, but provider uptake remains low in Africa. We aim to assess NT-proBNP provider’s uptake and determine factors associated with elevated values in HF patients in Douala. Methodology. We conducted a cross-sectional study with retrospective data gathering at three hospitals in Douala. All patients with HF managed in our settings between January 2016 and December 2022 were included. Elevated NT-proBNP values were defined based on the age-stratified cut-off recommended by the European Society of Cardiology guidelines. Associations were evaluated using logistic regression analysis with significant p value < 0.05. Results. Out of 1108 files with HF, 165 (16%) files had NT-proBNP results. The median age was 64 years with a female predominance 53.9%. The median NT-proBNP value was 1103pg/ml and elevated NT-proBNP was prevalent in 58.8% of the population. Elevated NT-proBNP values were found to be significantly associated with NYHA stage III dyspnea (OR=3.325, p=0.044) and Acute decompensated chronic HF (OR=5.004 p=0.028). Conclusion. NT-proBNP was used in less than one-quarter of HF patients having HF, but elevated values were prevalent in two of every three patients. Furthermore, this elevated NT-proBNP values was associated with the severity and time-course of HF. Clinicians must be sensitized on the utility of this cardiac biomarker