The main findings in the present study were (1) P4NP 7S declined in parallel to a decline in BNP, whereas PIIINP did not markedly change during hospitalisation; (2) patients discharged with high P4NP 7S were at high risk of HF readmission, especially within 90 days of discharge; and (3) P4NP 7S, when added on the established risk factors better improved the prediction of early cardiac death and HF hospitalisation than conventional LFTs and PIIINP. The gene discussed is NPPB; the disease is hydrops fetalis.