Abstract 10851: Short- and Long-Term Outcome and Risk Stratification by Multi-biomarkers in Patients with Chronic Heart Failure
Background: B-type natriuretic peptide (BNP), heart-type fatty acid binding protein (H-FABP), pentraxin 3 (PTX3), and cystatin C each predicts adverse cardiac events in chronic heart failure (CHF). We investigated that the utility of combination of these 4 biomarkers to reveal different pathogenic features of heart failure during short- and long-term (4-year).
Methods and Results: We measured BNP (associated with left ventricular dysfunction, positive if >200 pg/ml), H-FABP (marker of myocardial damage, positive if >4.3 ng/ml), PTX3 (marker of inflammation, positive if >4.0 ng/ml), and cystatin C (marker of glomerular filtration rate, positive if >1.0 ng/ml) in 95 CHF patients. During a median 500 days, 40 patients had cardiac events (death from any cause and readmission for worsening heart failure). In univariate Cox proportional analysis, each of elevated biomarkers predicted cardiac events. When categorized on the basis of the number of elevated biomarkers, patients with 2, 3, and 4 elevated biomarkers had a 11.1-fold (p<0.05), 22.4-fold (p<0.01), and 48.8-fold increase (p<0.001), in the risk of adverse cardiac events adjusted for age and sex compared with those without and with 1 elevated biomarker. Kaplan-Meier analysis revealed that cardiac event rates increased markedly as multi-biomarkers score rose (Figure). One- and overall total cardiac event rates were 0% and 4.7% in patient with score 0–1, 4.8% and 33.3% in patients with score 2, 28.0% and 56.0% in patients with score 3, and 63.6% and 81.8% in patients with score 4, respectively.
Conclusion: Risk stratification of using multi-these biomarkers was useful to predict cardiac events patients with CHF during short- and long-term.
- © 2010 by American Heart Association, Inc.