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Chromogranin A and C-terminal endothelin-1 precursor fragment add independent prognostic information to amino-terminal proBNP in patients with acute destabilized heart failure

Dieplinger, Benjamin, Gegenhuber, Alfons, Struck, Joachim, Poelz, Werner, Langsteger, Werner, Haltmayer, Meinhard und Mueller, Thomas (2009) Chromogranin A and C-terminal endothelin-1 precursor fragment add independent prognostic information to amino-terminal proBNP in patients with acute destabilized heart failure. Clinica Chimica Acta; international journal of clinical chemistry, 400 (1-2). pp. 91-96. ISSN 1873-3492

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Kurzfassung

BACKGROUND The aim of this study was to evaluate the prognostic value of chromogranin A (CgA) and C-terminal endothelin-1 precursor fragment (CT-proET-1) in patients with acute destabilized heart failure. METHODS 137 consecutive patients with acute destabilized heart failure attending the emergency department of a tertiary care hospital were prospectively enrolled. Plasma concentrations of CgA, CT-proET-1, and amino-terminal proBNP (NT-proBNP) were measured at baseline. The endpoint was defined as all-cause mortality; the study participants were followed up for 365 days. RESULTS Decedents (n=41) had higher median plasma concentrations of CgA (9.7 vs. 6.0 nmol/L; p=0.002), CT-proET-1 (120 vs. 72 pmol/L; p=0.006), and NT-proBNP (5112 vs. 2610 ng/L; p<0.001) at baseline than survivors (n=96). Applying Cox proportional-hazards regression analyses, increased CgA (>6.6 nmol/L), CT-proET-1 (>79 pmol/L), and NT-proBNP (>3275 ng/L) revealed significant risk ratios of 1.96 (95% CI, 1.04-3.70) for CgA, 2.56 (95% CI, 1.33-4.95) for CT-proET-1, and 2.05 (95% CI, 1.09-3.87) for NT-proBNP. When the cohort was stratified according to median CgA and NT-proBNP concentrations, and to median CT-proET-1 and NT-proBNP concentrations, respectively, Cox proportional-hazards regression analyses showed the highest risk for death in patients with both increased CgA and NT-proBNP (risk ratio, 3.65; 95% CI, 1.44-9.28), and increased CT-proET-1 and NT-proBNP (risk ratio, 4.03; 95% CI, 1.61-8.88). CONCLUSIONS Our study demonstrates that increased CgA and CT-proET-1 plasma concentrations at the initial presentation of patients with acute destabilized heart failure in the emergency department add independent prognostic information in addition to NT-proBNP measurement.

Typ des Eintrags: Fachpublikation (peer reviewed)
Bereiche: Ordensklinikum Linz Barmherzige Schwestern > Nuklearmedizin
Benutzer: Prof. Werner Langsteger
Hinterlegungsdatum: 19 Mär 2019 11:57
Letzte Änderung: 19 Mär 2019 11:57
URI: http://eprints.vinzenzgruppe.at/id/eprint/8583

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