Pro-A-Type Natriuretic Peptide, Proadrenomedullin, and N-Terminal Pro-B-Type Natriuretic Peptide Used in a Multimarker Strategy in Primary Health Care in Risk Assessment of Patients With Symptoms of Heart Failure

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Alehagen, UrbanÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken US (författare)

Pro-A-Type Natriuretic Peptide, Proadrenomedullin, and N-Terminal Pro-B-Type Natriuretic Peptide Used in a Multimarker Strategy in Primary Health Care in Risk Assessment of Patients With Symptoms of Heart Failure

Artikel/kapitelEngelska2013

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Elsevier,2013
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LIBRIS-ID:oai:DiVA.org:liu-89640
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-89640URI
https://doi.org/10.1016/j.cardfail.2012.11.002DOI

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Språk:engelska
Sammanfattning på:engelska

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Funding Agencies|County Council of Ostergotland||Swedish Heart and Lung Foundation||University of Linkoping||
Objective: Use of new biomarkers in the handling of heart failure patients has been advocated in the literature, but most often in hospital-based populations. Therefore, we wanted to evaluate whether plasma measurement of N-terminal pro B-type natriuretic peptide (NT-proBNP), midregional pro A-type natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM), individually or combined, gives prognostic information regarding cardiovascular and all-cause mortality that could motivate use in elderly patients presenting with symptoms suggestive of heart failure in primary health care. less thanbrgreater than less thanbrgreater thanMethods and Results: The study included 470 elderly patients (mean age 73 years) with symptoms of heart failure in primary health care. All participants underwent clinical examination, 2-dimenstional echocardiography, and plasma measurement of the 3 propeptides and were followed for 13 years. All mortality was registered during the follow-up period. The 4th quartiles of the biomarkers were applied as cutoff values. NT-proBNP exhibited the strongest prognostic information with andgt;4-fold increased risk for cardiovascular mortality within 5 years. For all-cause mortality MR-proADM exhibited almost 2-fold and NT-proBNP 3-fold increased risk within 5 years. In the 5-13-year perspective, NT-proBNP and MR-proANP showed significant and independent cardiovascular prognostic information. NT-proBNP and MR-proADM showed significant prognostic information regarding all-cause mortality during the same time. In those with ejection fraction (EF) andlt;40%, MR-proADM exhibited almost 5-fold increased risk of cardiovascular mortality with 5 years, whereas in those with EF andgt;50% NT-proBNP exhibited andgt;3-fold increased risk if analyzed as the only biomarker in the model. If instead the biomarkers were all below the cutoff value, the patients had a highly reduced mortality risk, which also could influence the handling of patients. less thanbrgreater than less thanbrgreater thanConclusions: The 3 biomarkers could be integrated in a multimarker strategy for use in primary health care. (J Cardiac Fail 2013;19:31-39)

Ämnesord och genrebeteckningar

Elderly
mulitmarker testing
heart failure
prognosis
MEDICINE
MEDICIN

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Dahlström, UlfÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken US(Swepub:liu)ulfda85 (författare)
Rehfeld, Jens F.University of Copenhagen, Denmark (författare)
Goetze, Jens P.University of Copenhagen, Denmark (författare)
Linköpings universitetKardiologi (creator_code:org_t)

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Ingår i:Journal of Cardiac Failure: Elsevier19:1, s. 31-391071-91641532-8414

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Journal of Cardiac Failure (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Alehagen, Urban; Dahlström, Ulf; Rehfeld, Jens F.; Goetze, Jens P.

Artiklar i publikationen: Journal of Cardi ...

Av lärosätet: Linköpings universitet

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