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Biomarkers in long-term prognosis of chronic heart failure formation in patients with acute coronary syndrome

Session Poster Session 1

Speaker Associate Professor Irina Vishnevskaya

Event : Heart Failure 2017

  • 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), OV Petyunina (Kharkiv,UA), NV Titarenko (Kharkiv,UA), YV Hilova (Kharkiv,UA)

IR Vyshnevska1 , MP Kopytsya1 , OV Petyunina1 , NV Titarenko1 , YV Hilova1 , 1Government institution“L.T. Malaya Therapy National institute of the National academy of medical sci - Kharkiv - Ukraine ,

European Journal of Heart Failure ( 2017 ) 19 ( Suppl. S1 ), 129

The progression of chronic heart failure (CHF) after acute coronary syndrome (ACS) significantly worsens the prognosis for this group of patients. Risk stratification of high risk patient of heart failure formation is very important. In order to diagnose this condition in time the search for biomarkers is going. One of them is the Growth differentiation factor 15 (GDF 15).
Purpose: to estimate the role of GDF 15 in the formation of CHF during the first year after ACS.
Methods: 73 patients were screened with different forms of ACS (55 male and 18 female), mean age was 61, 8 ± 1, 3 years. Among them, 54% patients with Q-wave myocardial infarction, 20% - with non-Q-wave myocardial infarction, 26% - unstable angina. All patients underwent a baseline investigation. In addition, the levels of GDF 15, N terminal-pro B-type natriuretic peptide (NT-pro BNP) were determined during the first day of hospitalization. The follow-up period was 1 year. The 6-minute walk test (6MWT) was performed for all patients after 1 year for exercise tolerance estimation. All patients were divided into four groups accordingly to the New York Heart Association (NYHA) guidelines (stages I-IV).
Results: the effect of various variables of clinical, instrumental and laboratory status were assessed on CHF progression. For identification of the main risk factors for adverse outcome, we have used logistic regression (LR) method: NT-pro BNP (area under curve (AUC) 0.54; p<0.8; 95% confidence interval (Cl): 0.31 – 0.72), level of serum creatinine (AUC 0.76; p<0.0002; 95% Cl: 0.62 – 0.90), GDF 15 (AUC 0.87; p<0.0001; 95% Cl: 0.79 – 0.96). NT- pro BNP had no predictive significance. During the statistical analysis the predictive value for estimated parameters was calculated: GDF 15 > 2508 pg/ml (specificity (Spe) 95%, sensitivity (Se) 68%), serum creatinine >118 µmol/l (Spe 86,6 %, Se 56 %). We have developed a LR model (p <0.0001, X2=14,75) with 88% of Se and 98% of Spe that can predict ?HF formation in patients during the first year after ACS.
Conclusion: the model can be used for risk stratification in development of CHF in patients after ACS in 1 year prognosis.

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