Predictive biomarkers for death and rehospitalization in comorbid frail elderly heart failure patients

Autor: Cristina Pacho, Mar Domingo, Raquel Núñez, Josep Lupón, Julio Núñez, Jaume Barallat, Pedro Moliner, Marta de Antonio, Javier Santesmases, Germán Cediel, Santiago Roura, M. Cruz Pastor, Jordi Tor, Antoni Bayes-Genis
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: BMC Geriatrics, Vol 18, Iss 1, Pp 1-10 (2018)
Druh dokumentu: article
ISSN: 1471-2318
DOI: 10.1186/s12877-018-0807-2
Popis: Abstract Background Heart failure (HF) is associated with a high rate of readmissions within 30 days post-discharge and in the following year, especially in frail elderly patients. Biomarker data are scarce in this high-risk population. This study assessed the value of early post-discharge circulating levels of ST2, NT-proBNP, CA125, and hs-TnI for predicting 30-day and 1-year outcomes in comorbid frail elderly patients with HF with mainly preserved ejection fraction (HFpEF). Methods Blood samples were obtained at the first visit shortly after discharge (4.9 ± 2 days). The primary endpoint was the composite of all-cause mortality or HF-related rehospitalization at 30 days and at 1 year. All-cause mortality alone at one year was also a major endpoint. HF-related rehospitalizations alone were secondary end-points. Results From February 2014 to November 2016, 522 consecutive patients attending the STOP-HF Clinic were included (57.1% women, age 82 ± 8.7 years, mean Barthel index 70 ± 25, mean Charlson comorbidity index 5.6 ± 2.2). The composite endpoint occurred in 8.6% patients at 30 days and in 38.5% at 1 year. In multivariable analysis, ST2 [hazard ratio (HR) 1.53; 95% CI 1.19–1.97; p = 0.001] was the only predictive biomarker at 30 days; at 1 year, both ST2 (HR 1.34; 95% CI 1.15–1.56; p
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