Abstract 832: Multiple Biomarkers Approach for Risk Stratification in Heart Failure Patients
Chronic heart failure (CHF) still represents the major cause of death and hospitalization. Thus, identification of high-risk patients is a major issue that remains challenging. It has been reported that brain natriuretic peptide (BNP), heart-type fatty acid-binding protein (H-FABP), and pentraxin 3 (PTX3) each predict adverse cardiac events in CHF patients. For prognostic evaluation from different aspects, we examined the utility of the combined measurements of 3 biomarkers (BNP, H-FABP, and PTX3) in patients with CHF. We measured levels of BNP (associated with left ventricular dysfunction, positive, if > 200 pg/ml), H-FABP (a marker of myocardial damage, positive, if > 4.1 ng/ml), and PTX3 (a marker of inflammation, positive, if > 4.0 ng/ml) in consecutive 164 CHF patients, and patients were prospectively followed with endpoints of cardiac death or re-hospitalization. When patients were categorized on the basis of the number of elevated biomarkers, patients with one, two, and three elevated biomarkers had a 5.4- (not significant), 11.2- (P < 0.05), and 34.6-fold increase (P < 0.01), respectively, in the risk of adverse cardiac events compared to those without elevated biomarkers. Kaplan-Meier analysis revealed that patients with three elevated biomarkers had a significantly higher cardiac event rate compared to patients with lower elevated biomarkers. The combination of these 3 biomarkers could reliably risk stratify CHF patients for the prediction of cardiac events.