Early risk stratification remains an important challenge in patients hospitalized with acute heart failure (AHF), particularly during the first year after admission. A retrospective cohort study presented at Heart Failure 2026 evaluated whether routinely available laboratory markers obtained at hospital admission were associated with short-, medium-, and long-term mortality outcomes in patients with AHF.

The analysis included consecutive patients admitted to a tertiary center between February and August 2024. Baseline laboratory assessments included hemoglobin, creatinine, sodium, potassium, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations. All-cause mortality was evaluated during hospitalization and at 1, 6, and 12 months of follow-up

Findings

• A total of 121 patients were included, with a median age of 81 years (IQR 75-87 years); 56.2% were men.
• All-cause mortality was 7.4% during hospitalization, 11.6% at 1 month, 21.5% at 6 months, and 32.2% at 12 months.
• Patients who died within 12 months had lower hemoglobin levels [11.6 (9.9-13.0) vs 12.7 (10.8-13.8) g/dL], higher creatinine concentrations [1.9 (1.4-2.4) vs 1.0 (0.9-1.4) mg/dL], and markedly higher NT-proBNP levels [15.9 (7.45-31.6) vs 5.3 (2.7-10.2) pg/mL].
• Kaplan-Meier analysis showed worse survival among patients with elevated NT-proBNP (χ²=14.9; P<0.001), elevated creatinine (χ²=25.1; P<0.001), and anemia (χ²=6.9; P=0.009).
• In multivariable Cox regression analysis, elevated creatinine (HR 3.51; 95% CI 1.58-7.80; P=0.002) and high NT-proBNP (HR 2.89; 95% CI 1.28-6.55; P=0.011) remained independently associated with higher 12-month mortality.

Admission creatinine and NT-proBNP levels were independently associated with 12-month mortality in patients hospitalized with AHF. The findings suggest that routinely available laboratory markers may help identify patients at higher risk after hospitalization, although additional studies are needed to further define their role in risk-guided management.