Circulating biological markers in prediction of clinical outcomes in patients with chronic heart failure
Keywords:chronic heart failure, biomarkers, cardiovascular risk, prognosis
The aim of this study was the creation of an evaluation cardiovascular risk score, based on an analysis of circulating biomarkers of CHF.
Methods: It was studied prospectively the incidence of fatal and non-fatal cardiovascular events, as well as the frequency of occurrence of death from any cause in a cohort of 194 patients with chronic heart failure during 3 years of observation. Circulating levels of NT-pro brain natriuretic peptide (NT-pro-BNP), galectin-3, high-sensitivity C-reactive protein (hs-CRP), osteoprotegerin, endothelial apoptotic microparticles (EAM) and endothelial progenitor cells (EPC) were measured at baseline.
Results: Median follow-up of patients included in the study was 2.76 years (range = 1.8–3.4 years). There were 285 cardiovascular events determined, including 43 deaths and 242 readmissions. Independent predictors of clinical outcomes in patients with CHF were NT-pro-BNP, galectin-3, hs-CRP, osteoprotegerin, CD14+CD309 +Tie2+ EPA, EAM and EAM/CD14+CD309+ EPA ratio. Index of cardiovascular risk was calculated by mathematical summation of all ranks of independent predictors, which occurred in the patients included in the study. The findings showed that the average value of the index of cardiovascular risk in patients with CHF was 3.17 units (95 % CI = 1.65–5.10 units). Kaplan–Meier analysis showed that patients with CHF and the magnitude of the risk of less than 4 units have an advantage in survival when compared with patients for whom obtained higher values of ranks cardiovascular risk score.
Conclusion: Assessment biomarker risk score of fatal and non-fatal cardiovascular events, constructed on measurement of circulating NT-pro-BNP, galectin-3, hs-CRP, osteoprotegerin, EAM and the ratio of the EAM/CD14+ CD309+ EPA, allowing ample reliably predict the probability survival of patients with CHF, regardless of age, gender, state of the contractile function of the myocardium of the left ventricle and the number of comorbidities.
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