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Cardiovascular biomarkers predict post-discharge rehospitalization risk and mortality among swedish heart failure patients

Session Poster Session 2

Speaker John Molvin

Event : Heart Failure 2018

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Diagnostic Methods: Biomarkers
  • Session type : Poster Session

Authors : J Molvin (Lund,SE), E Bachus (Malmö,SE), W Gallo (Malmö,SE), G Tasevska-Dinevska (Lund,SE), H Holm (Malmö,SE), A Jujic (Malmö,SE), O Melander (Malmö,SE), A Fedorowski (Malmö,SE), M Magnusson (Lund,SE)

Authors:
J Molvin1 , E Bachus2 , W Gallo2 , G Tasevska-Dinevska1 , H Holm2 , A Jujic2 , O Melander2 , A Fedorowski2 , M Magnusson1 , 1Lund University, Department of Cardiology, Skåne University Hospital, Malmö - Lund - Sweden , 2Department of Clinical Sciences, Lund University, Skåne University Hospital - Malmö - Sweden ,

On behalf: HARVEST

Citation:

Background/purpose: Here we aimed to analyse biomarkers related with neuroendocrine responses and cardiovascular stress (mid-regional pro-adrenomedullin (MR-proADM), copeptin, C-terminal pro-endothelin-1 (CT-pro-ET1) and N-terminal pro-brain natriuretic peptide (NT-proBNP)) and renal function (cystatin C) to test their predictive role in regard to mortality and risk of rehospitalization in a Swedish prospective heart failure (HF) patient cohort.

Methods: Two-hundred-and-sixty-eight patients hospitalized for HF (mean age: 75 years; 29% women) had complete data on all variables used in the analyses. Relations between baseline biomarker plasma concentrations and death as well as rehospitalization risk due to cardiac causes were assessed using multivariable Cox regression analysis adjusting for age, sex, body-mass index, systolic blood pressure, NYHA-class at hospitalisation, diabetes, total cholesterol, high-density lipoprotein, prevalent atrial fibrillation and smoking. A two-sided Bonferroni-corrected p-value of 0.05/5=0.010 was considered statistically significant;

Results: During follow-up period (mean time, 17±12 months), a total of 57 patients died. In the multivariable-adjusted Cox regression analysis, all the biomarkers except CT-pro-ET1 (hazard ratio (HR) per 1SD: 1.42, 95% confidence interval (CI), 1.03-1.95; p=0.034) were significantly associated with increased risk of death; NT-proBNP (HR, 1.85; CI, 1.17-2.17; p=4.0x10-4), MR-proADM (HR, 1.72; CI, 1.22-2.41; p=2.2x10-4), copeptin (HR, 1.70; CI, 1.22-2.36; p=0.0002), and cystatin C (HR, 2.11; CI, 1.56-2.86; p=1.0x10-6). A total of 178 patients were rehospitalized (mean follow-up time, 9±8 months) due to cardiac causes. NT-proBNP was the only biomarker that showed significant association with risk of 1st rehospitalization due to cardiac causes ((HR, 1.47; CI, 1.13-1.91; p=0.005).

Conclusion: Among patients hospitalised for HF, elevated plasma levels of NT-proBNP, MR-proADM, copeptin and cystatin C are significantly associated with increased risk of death after discharge, whereas NT-proBNP is the only biomarker that independently predicts the risk of rehospitalization.

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