Plasma asymmetric dimethylarginine and mortality in patients with acute decompensation of chronic heart failure
| Autor: | Stamatis S. Makrygiannis, Dimitrios Velissaris, Pelagia C. Batika, Stavros Tzerefos, Athanasios A. Prekates, George Z. Tsiaousis, Nikoloas G Patsourakos, Kyriakos S Argyrakis, Andreas Melidonis, Stefanos G. Foussas, Michael N. Zairis, Anastassios Theodossis Georgilas |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Heart disease Kaplan-Meier Estimate Arginine Risk Assessment Sensitivity and Specificity Hospitals University chemistry.chemical_compound Predictive Value of Tests Internal medicine medicine Humans Decompensation Enzyme Inhibitors Survival rate Aged Heart Failure Inpatients Ejection fraction Greece business.industry Incidence Stroke Volume Stroke volume Length of Stay Prognosis medicine.disease Surgery Survival Rate chemistry Predictive value of tests Heart failure Cardiology Female Endothelium Vascular Cardiology and Cardiovascular Medicine business Asymmetric dimethylarginine Biomarkers Follow-Up Studies |
| Zdroj: | Heart. 98:860-864 |
| ISSN: | 1468-201X 1355-6037 |
| DOI: | 10.1136/heartjnl-2011-301372 |
| Popis: | To investigate the prognostic value of circulating levels of asymmetric dimethylarginine (ADMA) in patients with acute decompensation of (New York Heart Association (NYHA) class III/IV) chronic heart failure and reduced left ventricular ejection fraction.Single-centre prospective observational study.Tertiary referral centre.A total of 651 consecutive and eligible hospitalised patients were studied. Patients were divided into four groups according to the quartiles of circulating levels of ADMA upon presentation.Incidence of in-hospital (or 7-day in the case of prolonged hospitalisation), 31-day and 1-year cardiac mortality were the pre-specified study end points.Cumulative rates of in-hospital, 31-day and 1-year cardiac mortality were 10.6%, 18.7% and 36.4%, respectively. There was a gradual increased risk of in-hospital (p(for trend)=0.011), 31-day (p(for trend)=0.044) and 1-year (p(for trend)0.001) mortality with increasing ADMA quartiles. After adjustment for possible confounders, patients at the highest ADMA quartile were at significantly higher risk for in-hospital (p=0.042), 31-day (p=0.032) and 1-year (p0.001) mortality than those in the lowest quartile.According to the present results, an elevated circulating level of ADMA is a strong independent predictor of short-term and long-term mortality in patients with acute decompensation of NYHA class III/IV chronic heart failure and reduced left ventricular ejection fraction. ADMA levels upon presentation may confer enhanced risk stratification in this setting. |
| Databáze: | OpenAIRE |
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