| Autor: |
Tromp, J. Ouwerkerk, W. Demissei, B. G. Anker, S. D. and Cleland, J. G. Dickstein, K. Filippatos, G. van der Harst, P. Hillege, H. L. Lang, C. C. Metra, M. Ng, L. L. and Ponikowski, P. Samani, N. J. van Veldhuisen, D. J. Zannad, F. Zwinderman, A. H. Voors, A. A. van der Meer, P. |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Popis: |
Aims We sought to determine subtypes of patients with heart failure (HF) with a distinct clinical profile and treatment response, using a wide range of biomarkers from various pathophysiological domains. Methods and results We performed unsupervised cluster analysis using 92 established cardiovascular biomarkers to identify mutually ex elusive subgroups (endotypes) of 1802 patients with HF and reduced ejection fraction (HFrEF) from the BIOSTAT-CHF project. We validated our findings in an independent cohort of 813 patients. Based on their biomarker profile, six endotypes were identified. Patients with endotype 1 were youngest, less symptomatic, had the lowest N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and lowest risk for all-cause mortality or hospitalization for HF. Patients with endotype 4 had more severe symptoms and signs of HF, higher NT-proBNP levels and were at highest risk for all-cause mortality or hospitalization for HF [hazard ratio (HR) 1.4; 95% confidence interval (Cl) 1.1-1.8]. Patients with endotypes 2, 3, and 5 were better uptitrated to target doses of beta-blockers (P < 0.02 for all). In contrast to other endotypes, patients with endotype 5 derived no potential survival benefit from uptitration of angiotensin-converting enzyme-inhibitoriangiotensin-II receptor blocker and beta-blockers (P-interaction |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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