J 2013

Incremental value of biomarkers to clinical variables for mortality prediction in acutely decompensated heart failure: The Multinational Observational Cohort on Acute Heart Failure (MOCA) study

LASSUS, Johan, Etienne GAYAT, Christian MUELLER, Frank W. PEACOCK, Jindřich ŠPINAR et. al.

Basic information

Original name

Incremental value of biomarkers to clinical variables for mortality prediction in acutely decompensated heart failure: The Multinational Observational Cohort on Acute Heart Failure (MOCA) study

Authors

LASSUS, Johan (246 Finland), Etienne GAYAT (250 France), Christian MUELLER (756 Switzerland), Frank W. PEACOCK (840 United States of America), Jindřich ŠPINAR (203 Czech Republic, guarantor, belonging to the institution), Veli-Pekka HARJOLA (246 Finland), Domingo PASCUAL-FIGAL (724 Spain), Said LARIBI (250 France), Damien LOGEART (250 France), Semir NOUIRA (788 Tunisia), Marco METRA (380 Italy), Roland von KIMMENADE (528 Netherlands), Atul PATHAK (250 France), Thomas MUELLER (40 Austria), Salvatore di SOMMA (380 Italy), Naoki SATO (392 Japan), Michael POTOCKI (756 Switzerland), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), Corinne COLLET (250 France), Alain COHEN-SOLAL (250 France), James L. Jr. JANUZZI (840 United States of America) and Alexandre MEBAZAA (250 France)

Edition

International Journal of Cardiology, Clare, ELSEVIER IRELAND LTD, 2013, 0167-5273

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 6.175

RIV identification code

RIV/00216224:14110/13:00070400

Organization unit

Faculty of Medicine

DOI

UT WoS

000326184400077

Keywords in English

ADHF; Mortality; Risk prediction; Biomarkers; Reclassification

Tags

International impact, Reviewed
Změněno: 15/4/2014 16:33, Ing. Mgr. Věra Pospíšilíková

Abstract

V originále

Aim: This study aims to evaluate the incremental value of plasma biomarkers to traditional clinical variables for risk stratification of 30-day and one-year mortality in acutely decompensated heart failure (ADHF). Methods and results: Through an international collaborative network, individual patient data on 5306 patients hospitalized for ADHF were collected. The all-cause mortality rate was 11.7% at 30 days and 32.9% at one year. The clinical prediction model (age, gender, blood pressure on admission, estimated glomerular filtration rate <60mL/min/1.73 m(2), sodium and hemoglobin levels, and heart rate) had a c-statistic of 0.74 for 30-day mortality and 0.73 for one-year mortality. Several biomarkers measured at presentation improved risk stratification when added to the clinical model. At 30 days, the net reclassification improvement (NRI) was 28.7% for mid-regional adrenomedullin (MR-proADM; p<0.001) and 25.5% for soluble (s) ST2 (p<.001). At one year, sST2 (NRI 10.3%), MR-proADM (NRI 9.1%), amino-terminal pro-B-type natriuretic peptide (NT-proBNP; NRI 9.1%), mid-regional proatrial natriuretic peptide (MR-proANP; NRI 7.4%), B-type natriuretic peptide (NRI 5.5%) and C-reactive protein (CRP; NRI 5.3%) reclassified patients with ADHF (p<0.05 for all). CRP also markedly improved risk stratification of patients with ADHF as a dual biomarker combination with MR-proADM (NRI 36.8% [p<0.001] for death at 30 days) or with sST2 (NRI 20.3%; [p<0.001] for one-year mortality). Conclusion: In this study, biomarkers provided incremental value for risk stratification of ADHF patients. Biomarkers such as sST2, MR-proADM, natriuretic peptides and CRP, reflecting different pathophysiologic pathways, add prognostic value to clinical risk factors for predicting both short-term and one-year mortality in ADHF.