Abstract 15866: Multiple Kidney Biomarkers Can Risk-Stratify Chronic Heart Failure Patients
Background:Previous studies have revealed that renal dysfunction is common in patients with heart failure. Estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) reflect renal function, which affects cardiac prognosis in chronic heart failure (CHF) patients. Higher urine beta 2-microglobulin-creatinine ratio (UBCR) implies renal tubular insufficiency,and reflect rapid renal deterioration. However, clinical importance of an overlying those parameters has not been determined in CHF patients. Therefore, the purpose of this study was to elucidate whether eGFR and UACR, UBCR can risk-stratify CHF patients.
Methods and Results:We measured levels of eGFR, UACR, and UBCR in 200 CHF patients (113 men and 87 women ). Patients were prospectively followed with endpoints of cardiac death or re-hospitalization for worsening CHF. We categorized 200 CHF patients using eGFR (positive if <60 ml/min/1.73m2), UACR (positive if >30mg/g), and UBCR (positive if ≥300μ g/g). Score was formed by assigning 1 point each for those (score 0-3). During a median follow-up period of 310 days, there were 50 cardiac events, including 10 cardiac deaths and 40 re-hospitalization for worsening heart failure. Patients with cardiac events showed lower eGFR and higher levels of BNP, UBCR and UACR compared to those without cardiac events. Moreover, patients with 1, 2, and 3 positive factors had a 6.6 -fold, 10.1 -fold, and 15.2 -fold increase in the risk of adverse cardiac events compared with those without risk factors, respectively. Kaplan-Meier analysis revealed that patients with higher score had a significantly higher rates of cardiac events than those with lower score.
Conclusion:Our findings suggest that the combination of these 3 markers could risk-stratify more accurately in CHF patients. .
- © 2012 by American Heart Association, Inc.