Multimarker Approach in Risk Stratification of Patients with Decompensated Heart Failure
| Autor: | O Yu Narusov, V N Protasov, A A Petrukhina, D E Protasova, V P Masenko, Skvortsov Aa, Tereshchenko Sn, T V Kuznetsova |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Troponin T business.industry Area under the curve 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine Copeptin Heart failure Internal medicine medicine Clinical endpoint Cardiology Decompensation 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Prospective cohort study Survival analysis |
| Zdroj: | Kardiologiia. 59:53-64 |
| ISSN: | 2412-5660 0022-9040 |
| Popis: | Purpose: to study prognostic value of various biomarkers and their combinations in patients who survived decompensation of chronic heart failure.Materials and methods.Patients (n=159) who were hospitalized with diagnosis of heart failure (HF) decompensation were included in a prospective single-center study. Examination on admission and the day of hospital discharge, included measurement of concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hsTnT), copeptin, soluble suppression of tumorigenicity 2 (sST2), kopetin, neutrophil gelatinase-associated lipocalin (NGAL), and galectin-3. Te combined primary endpoint comprised cardiovascular (CV) death, frst hospitalization because of HF heart failure decompensation, episodes of HF deterioration which required additional i/v diuretics, and CV death with successful resuscitation.Results.During one-year follow-up 56 pts (35.2%) reached the combined primary endpoint. Tere were 78 (49.1%) cardiovascular events. During hospitalization, patients with the decompensation of heart failure experienced a decrease of sST2, NT-proBNP, galectin-3, kopetin, hsTnT and an insignifcant increase of NGAL. ROC analysis identifed signifcant relation between concentrations of NT-proBNP, sST2, copeptin and, to a lesser degree, hsTnT, determined at hospital discharge, and risk of combined primary endpoint during 1-year follow-up: area under the curve (AUC) was 0.733 [95% CI 0.645–0.820], pConclusion.Patients with three and more elevated markers at hospital discharge have high risk of adverse events. Te biggest prognostic value has combination of sST2 and NT-proBNP concentrations. In order to determine the long-term prognosis of a patient with HF decompensation, it is sufcient to measure concentrations of sST2 and NT-proBNP at hospital discharge. Alternatively, it is possible to limit to sST2 only, which is just insignifcantly inferior to the sST2 and NT-proBNP combination. Patients with concentrations of sST2 ≥37.8 hg/ml and NT-proBNP ≥1696 rg/ml at hospital discharge have maximal 1year risk of death due to recurrent HF decompensation. |
| Databáze: | OpenAIRE |
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