Objectives/Methods: To determine whether NT-proBNP can predict hospitalization or cardiac death in patients whose first clinical manifestation was dCMP, we measured serial NT-ProBNP levels and echocardiography at the time of first manifestation of HF at OPD or at the time of admission, <1 month or pre-discharge, 3-6 months after, and annually. 279 patients whose LVESD > 45 mm or LVEDD >55 mm by echocardiography at the time of HF diagnosis were enrolled. We excluded patients with Cr > 2.0 mg/dL, ischemic CMP after AMI or OMI. The cardiac events were defined as 1) cardiovascular death, 2) Hospitalization because of HF in OPD or discharged patients. Results: Mean follow-up was 736짹31 days (39-1860 days). Cardiac events were coccred in 90 patients (32.3%), death in 37 and hospitalization in 53. The event free survival rates were 0.82 at 1 year and 0.46 at 5 year. Overall survival rates were 0.94 at 1 year, 0.70 at 5 year. Serial NT proBNP levels were higher in event (+) group. Among the echocardiography parameters only initial EF were lower in events (+) group. The optimal cut-off value of the midterm NT-proBNP levels (measured at 3-6 months after first manifestation of HF) of ROC curve was 1000 pg/ml (AUC 0.787, sensitivity 0.776). The hazard ratio was 8.463 (P<0.001) Conclusions: For the optimal treatment of dCMP in OPD, the serial tests of NT proBNP and the effort to lower the NT proBNP levels below 1000 pg/ml may be helpful to prevent CV outcomes. This value may be used as therapeutic monitoring or prognostic guideline for dCMP treatment.