Multimarker strategy for the prediction of 31 days cardiac death in patients with acutely decompensated chronic heart failure

Zairis, Michael N.; Tsiaousis, George Z.; Georgilas, Anastassios Theodossis; Makrygiannis, Stamatis S.; Adamopoulou, Evdokia N.; Handanis, S.; Batika, Pelagia; Prekates, A.; Velissaris, Dimitris; Kouris, Nikolaos; Mytas, D.; Babalis, Dimitris; Karidis, K.; Foussas, Stefanos

doi:10.1016/j.ijcard.2008.12.017

Cited by 69 publications

(48 citation statements)

References 23 publications

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“…In the Australia-New Zealand Heart Failure Study, above-median levels of MRproADM predicted increased risk of mortality (risk ratio, 3.92; 95% CI, 1.76-8.7) and of HF hospitalization (risk ratio, 2.4; 95% CI, 1.3-4.5) independently of traditional clinical and echocardiographic factors. 145 Treatment with carvedilol reduced the risk of death or HF hospitalization in patients with above-median levels of NT-proBNP, MR-proADM, or both. Although promising for predicting short-term prognosis, more studies are needed to determine the utility and prognostic value of MR-proADM in HF.…”

Section: Midregional Proadrenomedullinmentioning

confidence: 96%

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Chow¹,

Maisel²,

et al. 2017

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Background and Purpose: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers. Methods: The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through December 2016. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or contemporary clinical practice recommendations. Results: A number of biomarkers associated with HF are well recognized, and measuring their concentrations in circulation can be a convenient and noninvasive approach to provide important information about disease severity and helps in the detection, diagnosis, prognosis, and management of HF. These include natriuretic peptides, soluble suppressor of tumorgenicity 2, highly sensitive troponin, galectin-3, midregional proadrenomedullin, cystatin-C, interleukin-6, procalcitonin, and others. There is a need to further evaluate existing and novel markers for guiding therapy and to summarize their data in a standardized format to improve communication among researchers and practitioners. Conclusions: HF is a complex syndrome involving diverse pathways and pathological processes that can manifest in circulation as biomarkers. A number of such biomarkers are now clinically available, and monitoring their concentrations in blood not only can provide the clinician information about the diagnosis and severity of HF but also can improve prognostication and treatment strategies.

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Section: Midregional Proadrenomedullinmentioning

confidence: 96%

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Chow¹,

Maisel²,

et al. 2017

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“…14 Elevated cardiac troponins (cTn+) are associated with increased mortality risk in those hospitalized with AHFS. [15][16][17][18][19] They have also been shown to be one of the most important factors associated with early death in patients presenting to the ED with HF. 20 However, predictors of HF death are not necessarily equally important predictors of readmission.…”

mentioning

confidence: 99%

Outcomes and Care of Patients With Acute Heart Failure Syndromes and Cardiac Troponin Elevation

Braga

Austin

et al. 2013

Circ: Heart Failure

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A cute heart failure (HF) syndrome (AHFS) is a major reason for visits to the emergency department (ED). 1,2 Patients with AHFS represent a heterogeneous group defined by new or worsening symptoms of HF that require urgent care. 3 Although several potential underlying or precipitating factors are implicated, ischemic heart disease contributes importantly as a pathogenetic factor in AHFS. 4 It is estimated that 50% to 70% of patients with AHFS have concomitant coronary artery disease; however, optimal management of ischemic heart disease among patients with HF presenting in the acute hospital setting has not been fully elucidated. [5][6][7][8] At the current time, the management of AHFS is directed toward symptom improvement because many putative targets for acute therapy have not yielded a mortality benefit. 9-11 Recent evidence from a clinical registry suggested that patients with AHFS who underwent coronary angiography in hospital had increased use of evidence-based therapies and revascularization procedures and experienced lower mortality rates than those not undergoing the invasive procedure.12 Furthermore, patients with AFHS who underwent coronary revascularization exhibited mortality risks that did not differ from those without coronary artery disease. 13 Although an early invasive investigation and a revascularization strategy similar to that for acute coronary syndromes provide interesting possibilities to improve survival in AHFS, randomized trials have not tested this hypothesis. Background-Cardiac troponins (cTn) may be elevated among patients with acute heart failure syndromes (AHFS). Original ArticleHowever, the optimal approach to management of AHFS with elevated cTn is unknown. Methods and Results-We compared the care and outcomes of 13 656 patients with AHFS seeking care in the emergency department stratified by presence (cTn+, n=1845, 13.5%) or absence (cTn−) of elevated troponin. Clinically abstracted data on patients who were admitted or discharged from the emergency department in Ontario, Canada (

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“…У больных с СН считается обоснованным измерение концентрации МНУП или N-МНУП для оценки прогноза или тяжести заболева-ния (класс рекомендаций I, уровень доказательности А) [22,[30][31][32][33][34][35]. Следует отметить, что, по сравнению с предыдущим вариантом рекомендаций, считается по-лезным измерение исходного уровня МНУП и/или кардиоспецифичного тропонина для оценки прогноза у больных с остро развившимся утяжелением СН (класс рекомендаций I, уровень доказательности А) [36][37][38][39][40][41][42][43][44]. Т.е., подчеркивается, что полезно оценивать уровень МНУП в момент госпитализации.…”

Section: Biomarkers Of Heart Failure биомаркеры сердечной недостаточнunclassified

“…Более высокие концентрации НУП в момент госпи-тализации обычно сопровождаются более высоким риском развития неблагоприятных клинических исхо-дов, включая смерть от любой причины и смерть от осложнений сердечно-сосудистых заболеваний (ССЗ), а также более высокой частотой развития осложнений и исходов, включенных в комбинированные показа-тели, в разные периоды наблюдения за больными с декомпенсированной СН [26,[38][39][40][41][42][43][44][45][46]. Аналогично па-тологические концентрации циркулирующего кардио-специфичного тропонина обычно выявляют у больных с остро развившейся декомпенсацией СН, часто в от-сутствие явных признаков ишемии миокарда или со-путствующей ишемической болезни сердца; причем, в таких случаях имеется связь с неблагоприятными Biomarkers of Heart Failure Биомаркеры сердечной недостаточности клиническими исходами и более высоким риском смерти [41,45,47,48].…”

Section: Biomarkers Of Heart Failure биомаркеры сердечной недостаточнunclassified

Integration of Biomarkers Into the Practice of Treating Patients With Heart Failure: The Role of Determining the Blood Level of Natriuretic Peptides

Gilyarevskiy

Голшмид

Kuzmina

2017

Racionalʹnaâ farmakoterapiâ v kardiologii

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1 Российская медицинская академия непрерывного профессионального образования Россия, 123995, Москва, ул. Баррикадная, 2/1 2 Научно-исследовательский институт скорой помощи имени Н. В. Склифосовского Россия, 129090, Москва, Большая Сухаревская пл., 3В статье обсуждается роль биомаркеров для установления диагноза сердечной недостаточности в разных клинических ситуациях. Приводятся доказательные данные, ставшие основанием для применения натрийуретических пептидов при предполагаемой сердечной недостаточно-сти. Обсуждается необходимость использования натрийуретических пептидов у больных с синдромом такоцубо. Обсуждается вопрос об ограни-ченной диагностической ценности использования натрийуретических пептидов у больных со сниженной функций почек, а также при дру-гих заболеваниях, при которых может увеличиваться концентрация натрийуретических пептидов в отсутствие сердечной недостаточности.Ключевые слова: сердечная недостаточность, натрийуретические пептиды, биомаркеры. A clinical role of biomarkers (especially, natriuretic peptides) is discussed in the article. The most important evidences of clinical effectiveness of using biomarkers in patients with suspected heart failure and in patients with confirmed diagnose of heart failure are reviewed. The need to use natriuretic peptides in patients with takotsubo syndrome is discussed. Limited diagnostic value of using natriuretic peptides in renal dysfunction, as well as in other diseases in which the concentration of natriuretic peptides may increase in the absence of heart failure, is also discussed.Keywords: heart failure, natriuretic peptides, biomarkers. ВведениеСовременную кардиологию невозможно себе представить без использования биомаркеров, позво-ляющих количественно оценить выраженность по-вреждения миокарда или его напряжение. Такие биомаркеры необходимы в определенных клиниче-ских ситуациях для установления или исключения ди-агноза инфаркта миокарда или сердечной недостаточности (СН). Использование биомаркеров позволяет у многих больных уточнить тактику лечения, либо отказаться от необоснованного применения те-рапии. Кроме того, оценка уровня соответствующих биомаркеров необходима для более точной страти-фикации риска развития осложнений заболевания сердца. В последнем варианте европейских клиниче-ских рекомендаций по тактике ведения больных с СН допускается, что в некоторых лечебных учреждениях может быть недоступно определение концентрации мозгового натрийуретического пептида (МНУП) в ка-честве стандартной тактики обследования больных с предполагаемой СН [1]. В этих же рекомендациях от-мечается роль повышенной концентрации МНУП и N-терминального фрагмента мозгового натрийуре-

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Multimarker strategy for the prediction of 31 days cardiac death in patients with acutely decompensated chronic heart failure

Cited by 69 publications

References 23 publications

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Outcomes and Care of Patients With Acute Heart Failure Syndromes and Cardiac Troponin Elevation

Integration of Biomarkers Into the Practice of Treating Patients With Heart Failure: The Role of Determining the Blood Level of Natriuretic Peptides

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