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Evaluation of biomarkers for prognosis in patients with acute coronary syndrome

Session Poster Session 2

Speaker Associate Professor Irina Vishnevskaya

Event : Acute Cardiovascular Care 2015

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes: Biomarkers
  • Session type : Poster Session

Authors : IR Vyshnevska (Kharkiv,UA), MP Kopytsya (Kharkiv,UA), NV Bila (Kharkiv,UA), OV Petyunina (Kharkiv,UA), OL Oparin (Kharkiv,UA), LL Peteneva (Kharkiv,UA), OJ Yukhnovskiy (Kharkiv,UA)

Authors:
IR Vyshnevska1 , MP Kopytsya1 , NV Bila1 , OV Petyunina1 , OL Oparin1 , LL Peteneva1 , OJ Yukhnovskiy1 , 1Government institution“L.T. Malaya Therapy National institute of the National academy of medical sci - Kharkiv - Ukraine ,

Citation:
European Heart Journal: Acute Cardiovascular Care ( 2015 ) 4 ( Supplement 5 ), S88

The search for new markers that significantly predict adverse outcomes in patients with acute coronary syndrome (ACS) is still going. Markers such as growth differentiation factor 15 (GDF 15), N terminal-pro B-type natriuretic peptide (NT-pro BNP), Heart-type fatty acid binding protein (H-FABP) are being actively studied.
Purpose: to determine the significance of new biomarkers in prognosis of 6-months death after ACS. Methods: 70 patients with different forms of ACS were included in the study, they were admitted to the hospital from 2012 to 2013, signed the informed consent: 77% men and 23% women, mean age was 61, 8 ± 1, 3 years. Among them, 54% patients with Q-wave myocardial infarction (Q-wave MI), 20% - with non-Q-wave myocardial infarction (non-Q-wave MI), 26% - unstable angina (UA). All patients underwent a baseline investigation which includes: standard electrocardiography, echocardiography, angiography, determination of marker of myocardial necrosis – cardiac troponin T. GRACE score has been used for risk stratification. In addition, the levels of GDF 15, NT-pro BNP and H-FABP were determined during the first day of hospitalization. The endpoint w all-cause mortality. During 6-months follow-up 11% patients died. Results: the effect of 60 variables of clinical, instrumental and laboratory status were assessed on surviving patients. For identification of the main risk factors for adverse outcome, we have used logistic regression (LR) method: GRACE score for 6-months death (area under curve (AUC) 0.95; p<0.00001; 95% confidence interval (Cl): 0.870 – 0.988), NT-pro BNP (AUC 0.89; p<0.0001; 95% Cl: 0.759 - 0.960), GDF 15 (AUC 0.8; p<0.0017; 95% Cl: 0.704 – 0.899), H-FABP (AUC 0.7; p<0.0009; 95% Cl: 0,630 - 0,766). There was a significant difference in NT-proBNP (p < 0.00001), H-FABP (p < 0.0023) and GDF 15 (p< 0.0001) serum levels between ACS patients who died and those who survived after 6 months. NT-proBNP cut-point level of 1,490 ng/mL, GDF 15 cut-point level of 2561 pg/ml and H-FABP cut-point level of 1,23 ng/ml are significant independent predictors of mortality.
Conclusions: The increased levels of NT-proBNP, GDF 15 and H-FABP together with GRACE score are the strongest and the most important predictors of 6-month mortality in ACS patients. They could be used in clinical practice to improve risk stratification of patients with ACS.

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