التفاصيل البيبلوغرافية
| العنوان: |
Soluble ST2, high-sensitivity troponin T- and N-terminal pro-B-type natriuretic peptide: complementary role for risk stratification in acutely decompensated heart failure. |
| المؤلفون: |
Pascual-Figal, Domingo A., Manzano-Fernández, Sergio, Boronat, Miguel, Casas, Teresa, Garrido, Iris P., Bonaque, Juan C., Pastor-Perez, Francisco, Valdés, Mariano, Januzzi, James L. |
| المصدر: |
European Journal of Heart Failure; Jul2011, Vol. 13 Issue 7, p718-725, 8p, 5 Charts, 2 Graphs |
| مصطلحات موضوعية: |
HEART failure, ACUTE diseases, ATRIAL natriuretic peptides, BIOMARKERS, LEFT heart ventricle, HEART disease related mortality, CONFIDENCE intervals, DISCRIMINANT analysis, PROGNOSIS |
| مستخلص: |
Aim To investigate the use of biomarkers providing independent information regarding physiology in acutely decompensated heart failure (ADHF) for assessment of risk. Methods and results This was a prospective study of 107 patients hospitalized with ADHF (mean age 72 ± 13 years, 44% male, left ventricular ejection fraction 47 ± 15%). Blood samples were collected on presentation to measure soluble (s)ST2, high-sensitivity troponin T (hsTnT), and amino-terminal pro-B type natriuretic peptide (NT-proBNP) levels. Clinical follow-up was obtained for all patients over a median period of 739 days, and all-cause mortality was registered. Concentrations of sST2 [per 10 ng/mL, hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.04–1.13; P< 0.001], hsTnT (per 0.1 ng/mL, HR 1.16, 95% CI 1.09–1.24; P< 0.001), and NT-proBNP (per 100 pg/mL, HR 1.01, 95% CI 1.003–1.01; P< 0.001) were each predictive of a higher risk of death. In bootstrapped models, each biomarker retained independent predictive value for mortality. Patients with all three biomarkers below their optimal cut-off at presentation were free of death (0%) during follow-up, whereas 53% of those with elevations of all three biomarkers had died. For each elevated marker (from 0 to 3) adjusted analysis suggested a tripling of the risk of death (for each elevated marker, HR 2.64, 95% CI 1.63–4.28, P< 0.001). Integrated discrimination analyses indicated that the use of these three markers in a multimarker approach uniquely improved prediction of death. Conclusions Biomarkers reflecting remodelling (sST2), myonecrosis (hsTnT), and myocardial stretch (NT-proBNP) provide complementary prognostic information in patients with ADHF. When used together, these novel markers provide superior risk stratification. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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