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Influence of body mass index on laboratory and biomarkers in acute heart failure patients

Session Poster Session 4

Speaker Koen Streng

Event : Heart Failure 2016

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

Authors : KW Streng (Groningen,NL), JM Ter Maaten (Groningen,NL), JG Cleland (London,GB), M Metra (Brescia,IT), MM Givertz (Boston,US), P Ponikowski (Wroclaw,PL), HL Hillege (Groningen,NL), DJ Van Veldhuisen (Groningen,NL), AA Voors (Groningen,NL), P Van Der Meer (Groningen,NL)

Authors:
KW Streng1 , JM Ter Maaten1 , JG Cleland2 , M Metra3 , MM Givertz4 , P Ponikowski5 , HL Hillege1 , DJ Van Veldhuisen1 , AA Voors1 , P Van Der Meer1 , 1University Medical Center Groningen, Department of Cardiology - Groningen - Netherlands , 2National Heart and Lung institute, Royal Brompton and Harefield Hospitals, Imperial College - London - United Kingdom , 3University of Brescia - Brescia - Italy , 4Brigham and Women's Hospital - Boston - United States of America , 5Wroclaw Medical University, Clinical Military hospital - Wroclaw - Poland ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2016 ) 18 ( Supplement 1 ), 491

Background: It is known plasma concentrations of natriuretic peptide decline with obesity in patients with heart failure. Whether this is true for other biomarkers is unknown. We investigated biomarker profiles in acute heart failure across the body mass index (BMI) spectrum. Methods: We acquired data and baseline plasma samples from 2033 patients in PROTECT; a trial comparing the effects of rolofylline to placebo in patients with acute heart failure, and measured 48 biomarkers, assessing multiple pathophysiological pathways. Patients were classified into four BMI groups (<25, 25-30, 30-35 and  > 35 kg/m2). Results: Of 2003 patients with known weight and height, the mean age was 70 ± 12 years and 67% were men. Patients with a higher BMI ( > 35 kg/m2) had higher blood pressures, were younger and more often women. Median levels of BNP were 550 pg/ml in patients with a BMI <25 kg/m2 and 319 pg/ml in patients with a BMI  > 35 kg/m2 (p < 0.001). Multivariable regression analysis revealed that BNP (β=-0.250, p < 0.001) and RAGE (β=-0.095, p < 0.007) were strongly inversely correlated to BMI, whereas higher levels of uric acid (β = 0.164, p < 0.001), proADM (β = 0.171, p < 0.001), creatinine (β = 0.118, p = 0.003), sodium (β = 0.101, p = 0.006) and bicarbonate (β = 0.094, p = 0.009) were associated with higher BMI. All betas are per standard deviation. Patients with a higher BMI had a lower 180-day mortality although this relationship was no longer significant on multivariable analysis. Conclusions: When assessing the clinical utility of biomarkers for patients with acute heart failure, BMI should be taken in to account. These findings suggest that these markers should be interpreted with caution in obese patients, and BMI should be included in multivariable analyses assessing the prognostic value of biomarkers in acute heart failure.

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