Triple head-to-head comparison of fibrotic biomarkers galectin-3, osteopontin and gremlin-1 for long-term prognosis in suspected and proven acute heart failure patients

• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Verfasst von: Fastner, Christian [VerfasserIn]
• Verfasst von: El-Battrawy, Ibrahim [VerfasserIn]
• Verfasst von: Lang, Siegfried [VerfasserIn]
• Verfasst von: Neumaier, Michael [VerfasserIn]
• Verfasst von: Borggrefe, Martin [VerfasserIn]
• Verfasst von: Hoffmann, Ursula [VerfasserIn]
• Titel: Triple head-to-head comparison of fibrotic biomarkers galectin-3, osteopontin and gremlin-1 for long-term prognosis in suspected and proven acute heart failure patients
• Verf.angabe: Michael Behnes, Thomas Bertsch, Christel Weiss, Parviz Ahmad-Nejad, Ibrahim Akin, Christian Fastner, Ibrahim El-Battrawy, Siegfried Lang, Michael Neumaier, Martin Borggrefe, Ursula Hoffmann
• Jahr des Originals: 2015
• Umfang: 9 S.
• Fussnoten: Gesehen am 10.01.2019 ; Available online 20 October 2015
• Titel Quelle: Enthalten in: International journal of cardiology
• Jahr Quelle: 2016
• Band/Heft Quelle: 203(2016), S. 398-406
• ISSN Quelle: 1874-1754
• DOI: doi:10.1016/j.ijcard.2015.10.127
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1586098586

Abstract

Background: To comparatively evaluate long-term prognostic values of fibrotic biomarkers galectin-3, gremlin-1 and osteopontin in patients presenting to the emergency department (ED) suspected of acute heart failure (AHF). Methods: Patients with acute dyspnea or peripheral edema were enrolled in the ED. Biomarkers were measured and added to prognostic models including 11 conventional risk factors plus NT-proBNP assessing state-of-the-art statistics of discrimination, calibration, reclassification and Cox regression analyses. Prognostic outcomes were long-term all-cause mortality (ACM) and AHF-related rehospitalization (AHF-RH) at 1 and 5years. Results: 401 patients including 122 AHF patients were enrolled (mean age 67years, males 51%). During 5years follow-up 129 patients (30%) died and 73 (18%) were re-hospitalized because of AHF. In multivariate analysis, galectin-3 (hazard ratios (HR) range 1.4-1.9; p=0.03) and osteopontin (HR range 1.2-1.4; p=0.001) remained associated with ACM overall and in the AHF population at 5years, whereas gremlin-1 remained associated with AHF-RH at 1year in AHF patients (HR 1.3; p=0.002). ACM in whole cohort was best discriminated (AUC=0.85, p=0.0001), calibrated and re-classified (NRI +0.50 to +0.56, p=0.0001) by galectin-3, whereas in AHF patients ACM was best discriminated by osteopontin (AUC range: 0.82-0.84, p=0.0001; NRI +0.34 to +0.38, p<0.1) and AHF-RH at 1year by gremlin-1 (AUC range: 0.82-0.92, p=0.0001; NRI +0.59 to +0.60, p=0.006). Conclusions: A panel of fibrotic biomarkers, including osteopontin, galectin-3 and gremlin-1, might be useful for long term risk-stratification of symptomatic ED patients being suspected of AHF.