Comparative evaluation of cardiac biomarkers including NT-proBNP, BNP, and galectin-3 in predicting heart failure prognosis and mortality

Abstract

Cardiac biomarkers guide heart failure diagnosis and prognosis, yet optimal marker combinations remain debated. This research compared the prognostic value of NT-proBNP, BNP, and galectin-3 in heart failure patients. A prospective cohort at Dar es Salaam Institute of Technology from January 2023 to May 2025 followed 248 heart failure patients for 18 months. Biomarkers were measured at baseline and correlated with outcomes including mortality and rehospitalization. NT-proBNP demonstrated the highest area under ROC curve for mortality prediction at 0.847, compared to 0.798 for BNP and 0.724 for galectin-3. Combining NT-proBNP with galectin-3 improved AUC to 0.891. Patients with both markers elevated showed 4.7-fold higher mortality risk than those with neither elevated. These findings support multi-marker strategies for heart failure risk stratification.