Abstract 13825: Profiling Determinants Reflective of Heart Failure and Matrix Remodeling Stratify Patients Presenting With Acute Dyspnea and Early Hospital Readmission
Introduction: Early readmission for heart failure (HF), defined as a HF admission within 30 days of hospital discharge, has become a focus of medical management and cost containment. Identifying patients at initial emergent presentation who are at high-risk for subsequent early readmission for HF would facilitate these efforts. B-type natriuretic peptide (BNP) measurement is used to identify patients presenting with acute dyspnea in the emergency department (ED) with potential HF as an underlying cause for their symptoms. Simultaneous measures of other biomarkers, such as the matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs), may discover previously unknown associations with subsequent early readmission for HF.
Methods and Results: Plasma samples collected from patients presenting to the ED with signs and symptoms of HF (n=390) were subjected to multiplex array for MMP/TIMPs (6 MMPs and 4 TIMPs) and BNP. Telephone/chart reviews were used to document early readmission or no readmission for HF at 30 days. In this patient cohort, 39 patients (10%) met the criteria for early readmission for HF and were found to have higher BNP, MMP-3, and TIMP-2 compared to patients without events. Moreover, when combining patient age with these biomarkers in a composite score; the median composite of age, BNP concentration, and MMP3 concentration was statistically significant (P=0.0022) for early readmission vs no readmission within 30 days.
Conclusions: These unique results support the concept that a biomarker profile, utilized at the time of initial presentation for dyspnea, may allow for the early identification of patients at subsequent risk for early HF readmission who may benefit from targeted interventional strategies.
- © 2013 by American Heart Association, Inc.