Novel and established biomarkers to complement risk scores in patients with acute decompensated heart failure - a pilot study

被引：0

作者：

Haehnel, Valentin ^{[1
,2
,3
]}

Meretz, Victoria ^{[1
,2
,3
]}

Butter, Christian ^{[1
,2
,3
]}

Paar, Vera ^{[4
]}

Edlinger, Christoph ^{[1
,2
,3
]}

Lichtenauer, Michael ^{[4
]}

Biemann, Ronald ^{[5
]}

Isermann, Berend ^{[5
]}

Hoffmeister, Meike ^{[2
,3
,6
]}

Haase, Michael ^{[7
,8
,9
]}

Haase-Fielitz, Anja ^{[2
,3
,9
]}

Bannehr, Marwin ^{[1
,2
,3
]}

机构：

[1] Univ Hosp Heart Ctr Brandenburg, Brandenburg Med Sch Theodor Fontane, Dept Cardiol, D-16321 Bernau, Germany

[2] Joint Fac Univ Potsdam, Fac Hlth Sci FGW, Brandenburg Med Sch Theodor Fontane, D-16816 Senftenberg, Germany

[3] Brandenburg Tech Univ Cottbus, D-16816 Senftenberg, Germany

[4] Paracelsus Med Univ Salzburg, Dept Cardiol, Clin Internal Med 2, A-5020 Salzburg, Austria

[5] Univ Hosp Leipzig, Inst Lab Med Clin Chem & Mol Diagnost, D-04103 Leipzig, Germany

[6] Inst Biochem, Brandenburg Med Sch Theodor Fontane, D-14770 Brandenburg, Germany

[7] Hannover Med Sch, Dept Nephrol & Hypertens, D-30625 Hannover, Germany

[8] Diamedikum Kidney Care Ctr, D-14473 Potsdam, Germany

[9] Otto Guericke Univ Magdeburg, Inst Social Med & Hlth Syst Res, D-39120 Magdeburg, Germany

来源：

AMERICAN HEART JOURNAL PLUS: CARDIOLOGY RESEARCH AND PRACTICE | 2025年 / 53卷

关键词：

Heart failure; Risk scores; Cardiorenal biomarker; Urine neutrophil gelatinase-associated lipocalin; Troponin; Cystatin C; GELATINASE-ASSOCIATED LIPOCALIN; PROBNP REDUCTION PERCENTAGE; IN-HOSPITAL MORTALITY; NATRIURETIC PEPTIDE; VENTRICULAR DYSFUNCTION; PREDICTING MORTALITY; TERM MORTALITY; STRATIFICATION; VALIDATION; DERIVATION;

D O I：

10.1016/j.ahjo.2025.100544

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Study Objective: There are several risk scores for mortality in patients with acute decompensated heart failure (ADHF) such as the European Collaboration on Acute Decompensated Heart Failure Score (ELAN-HF Score), the ADHF/NT-proBNP-Score or A2B-Score (age, anemia, BNP). The aim of this study was to evaluate the predictive value of such risk scores with and without addition of novel cardiorenal biomarkers. Design & Setting: Single-center, exploratory prospective cohort study at the University Hospital Heart Centre Brandenburg. Participants: Forty-four adult patients hospitalized for ADHF. Interventions: Measurement of established and novel biomarkers at hospital admission including N-terminal-pro brain natriuretic peptide (NT-pro-BNP), troponin T, creatinine, cystatin C, soluble suppression of tumorigenicity 2 (sST2), Neprilysin, Dickkopf-3 (DKK3), interleukin-6 (IL-6), growth differentiation factor-15 (GDF-15), Galectin-3, Progranulin and urine neutrophil gelatinase-associated lipocalin (uNGAL). Main Outcome Measures: Analysis of predictive indices of ELAN-HF, ADHF/NT-proBNP and A2B-Scores for 90-day mortality with and without adding biomarkers. AUC <0.8 was considered as fair, >= 0.8 as good and > 0.9 as excellent predictive value. Results: Median age was 78.0 (25th-75th percentiles 69.3-83.8) years, 50 % (22/44) were female. Twelve patients (27.3 %) died within 90 days after discharge. All three risk scores were higher in non-survivors and showed fair AUC for 90-day mortality (ELAN-HF: 0.792 [0.639-0.901], p = 0.003; ADHF-NT-proBNP score: 0.749 [0.559-0.938], p = 0.012; A2B score: 0.734 [0.541-0.927], p = 0.017). Adding troponin T, cystatin C-based estimated glomerular filtration rate (eGFR) or uNGAL to risk scores was associated with an area under the curve (AUC) >0.80 for all models. Combination of troponin T, cystatin C-based eGFR and uNGAL increased risk scores to AUC >0.91. Conclusion: These findings imply that further evaluation of the addition of a panel of cardiorenal biomarkers to ADHF risk scores is warranted.

引用

页数：9

共 44 条

[1] NT-ProBNP reduction percentage during admission for acutely decompensated heart failure predicts long-term cardiovascular mortality [J].