British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 2, Issue.: 4 (October-December)
Original Research Article
Steady-State Levels of Troponin and Brain Natriuretic Peptide for Prediction of Long-Term Outcome after Acute Heart Failure with or without Stage 3 to 4 Chronic Kidney Disease
Yutaka Endo1*, Shun Kohsaka1, Toshiyuki Nagai1, Kimi Koide1, Masashi Takahashi1, Yuji Nagatomo1, Kazuki Oshima1, Hiroaki Miyata2, Keiichi Fukuda1 and Tsutomu Yoshikawa3
1Division of Cardiology, Keio University School of Medicine, Tokyo, Japan
2Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
3Director, Division of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Aim: To determine whether assessment of a combination of steady-state discharge levels of biomarkers improves risk stratification after acute decompensate HF.
Study Design: Retrospective cohort study.
Place and Duration of Study: Keio University Hospital, between January 2006 and September 2011.
We analyzed 244 patients with acute HF due to ischemic or dilated cardiomyopathy who were enrolled in a prospective, single institution-based registry between January 2006 and September 2011. Patients were stratified by discharge values of BNP and/or TnT. The primary endpoint was a composite of HF readmission or death during the 2-year period after discharge.
Results: The population was predominantly male (69.3%), and the mean age was 66.6±15.3 years. Patients with higher BNP levels or detectable TnT had a worse prognosis (BNP45.0% vs. 18.8%, p<0.001; TnT 43.8% vs. 25.1%, p=0.002, respectively). The primary event rate was additively worse among patients with both increased BNP levels and detectable TnT compared to those with increased levels of BNP or detectable TnT alone (log-rank p<0.001). A similar trend was observed in the subgroup of patients with CKD stage III–V (n=172).
Conclusion: Assessment of both BNP and TnT values may have a significant predictive value for HF prognosis, even among patients with CKD, a condition affecting biomarker levels.
Biomarkers; heart failure; chronic kidney disease.
Full Article - PDF
DOI : 10.9734/BJMMR/2012/1384