Worsening renal failure in patients with acute heart failure: the importance of cardiac biomarkers.
Acute Kidney Injury
/ etiology
Aged
Aged, 80 and over
Biomarkers
/ blood
Creatinine
/ metabolism
Disease Progression
Fatty Acid Binding Protein 3
/ metabolism
Female
Follow-Up Studies
Glomerular Filtration Rate
Heart Failure
/ complications
Humans
Kidney Function Tests
Lipocalin-2
/ metabolism
Male
Middle Aged
Prognosis
Retrospective Studies
Time Factors
Acute kidney injury
Heart-type fatty acid-binding protein
Liver fatty acid-binding protein
Mortality
Neutrophil gelatinase-associated lipocalin
Journal
ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
12
09
2018
accepted:
08
01
2019
pubmed:
26
2
2019
medline:
17
5
2019
entrez:
26
2
2019
Statut:
ppublish
Résumé
The importance of true worsening renal failure (WRF), which is associated with a poor prognosis, had been suggested in patients with acute heart failure (AHF). The aim of the present study was to establish the biomarker strategy for the prediction of true WRF in AHF. Two hundred eighty-one patients with AHF were analysed. Their biomarkers were measured within 30 min of admission. Patients were assigned to the non-WRF (n = 168), pseudo-WRF (n = 56), or true-WRF (n = 57) groups using the criteria of both acute kidney injury on admission and increasing serum creatinine value during the first 7 days. A Kaplan-Meier curve showed that the survival and heart failure event rate of the true-WRF group within 1000 days was significantly lower than that of the non-WRF and pseudo-WRF groups (P ≤ 0.001). The multivariate Cox regression model also indicated that true WRF was an independent predictor of 1000 day mortality and heart failure events [hazard ratio: 4.315, 95% confidence interval (CI): 2.466-7.550, P ≤ 0.001, and hazard ratio: 2.834, 95% CI: 1.893-4.243, P ≤ 0.001, respectively]. The serum heart-type fatty acid-binding protein (s-HFABP) levels were significantly higher in the true-WRF group than in the non-WRF and pseudo-WRF groups (P ≤ 0.001). The multivariate logistic regression model indicated that the predictive biomarker for the true-WRF group was the s-HFABP level (odds ratio: 5.472, 95% CI: 2.729-10.972, P ≤ 0.001). The sensitivity and specificity for indicating the presence of true WRF were 73.7% and 76.8% (area under the curve = 0.831) for s-HFABP in whole patients, respectively, and 94.7% and 72.7% (area under the curve = 0.904) in non-chronic kidney disease (CKD) patients, respectively. Cardiac biomarkers, especially the s-HFABP, might predict the development of true WRF in AHF patients. Furthermore, the predictive value was higher in AHF patients without CKD than in those with CKD.
Identifiants
pubmed: 30801997
doi: 10.1002/ehf2.12414
pmc: PMC6437438
doi:
Substances chimiques
Biomarkers
0
FABP3 protein, human
0
Fatty Acid Binding Protein 3
0
Lipocalin-2
0
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
416-427Informations de copyright
© 2019 The Authors ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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