In: BMC Cardiovascular Disorders, 15 (2015), Nr. 50. S. 1-12. ISSN 1471-2261
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Abstract
Background: To evaluate diagnostic and long-term prognostic values of hFABP compared to NT-proBNP and troponin I (TnI) in patients presenting to the emergency department (ED) suspected of acute heart failure (AHF). Methods: 401 patients with acute dyspnea or peripheral edema, 122 suffering from AHF, were prospectively enrolled and followed up to 5 years. hFABP combined with NT-proBNP versus NT-proBNP alone was tested for AHF diagnosis. Prognostic value of hFABP versus TnI was evaluated in models predicting all-cause mortality (ACM) and AHF related rehospitalization (AHF-RH) at 1 and 5 years, including 11 conventional risk factors plus NT-proBNP. Results: Additional hFABP measurements improved diagnostic specificity and positive predictive value (PPV) of sole NT-proBNP testing at the cutoff <300 ng/l to “rule out” AHF. Highest hFABP levels (4th quartile) were associated with increased ACM (hazard ratios (HR): 2.1–2.5; p = 0.04) and AHF-RH risk at 5 years (HR 2.8–8.3, p = 0.001). ACM was better characterized in prognostic models including TnI, whereas AHF-RH was better characterized in prognostic models including hFABP. Cox analyses revealed a 2 % increase of ACM risk and 3–7 % increase of AHF-RH risk at 5 years by each unit increase of hFABP of 10 ng/ml. Conclusions: Combining hFABP plus NT-proBNP (<300 ng/l) only improves diagnostic specificity and PPV to rule out AHF. hFABP may improve prognosis for long-term AHF-RH, whereas TnI may improve prognosis for ACM. Trial registration: ClinicalTrials.gov identifier: NCT00143793 .
Dokumententyp: | Artikel |
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Titel der Zeitschrift: | BMC Cardiovascular Disorders |
Band: | 15 |
Nummer: | 50 |
Verlag: | BioMed Central |
Ort der Veröffentlichung: | London |
Erstellungsdatum: | 09 Dez. 2015 08:56 |
Erscheinungsjahr: | 2015 |
ISSN: | 1471-2261 |
Seitenbereich: | S. 1-12 |
Institute/Einrichtungen: | Medizinische Fakultät Mannheim > Institut für Klinische Chemie
Medizinische Fakultät Mannheim > Medizinische Klinik - Lehrstuhl für Innere Medizin I Medizinische Fakultät Mannheim > Core Facility Medizinische Statistik |
DDC-Sachgruppe: | 610 Medizin |