scholarly journals Analyzing Dynamic Changes of Laboratory Indexes in Patients with Acute Heart Failure Based on Retrospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-10
Author(s):  
Yurong Wang ◽  
Lei Fu ◽  
Qian Jia ◽  
Hao Yu ◽  
Pengjun Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Troponin T ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Adverse Outcomes ◽  
Control Group ◽  
Dynamic Changes ◽  
Reactive Protein

Background. Changes of N-terminal probrain natriuretic peptide (NT-proBNP) have been studied whether in the long term or the short term in patients of acute heart failure (AHF); however, changes of NT-proBNP in the first five days and their association with other factors have not been investigated.Aims. To describe the dynamic changes of relevant laboratory indexes in the first five days between different outcomes of AHF patients and their associations.Methods and Results. 284 AHF with dynamic values recorded were analyzed. Changes of NT-proBNP, troponin T, and C-reactive protein were different between patients with different outcomes, with higher values in adverse group than in control group at the same time points (p<0.05). Then, prognostic use and risk stratification of NT-proBNP were assessed by receiver-operating characteristic curve and logistic regression. NT-proBNP levels at day 3 showed the best prognostic power (area under the curve = 0.730, 95% confidence interval (CI): 0.657 to 0.794) and was an independent risk factor for adverse outcome (odds ratio, OR: 2.185, 95% CI: 1.584–3.015). Classified changes of NT-proBNP may be predictive for adverse outcomes in AHF patients.Conclusions. Sequential monitoring of laboratory indexes within the first 5 days may be helpful for management of AHF patients.

scholarly journals Complement activation products in acute heart failure: Potential role in pathophysiology, responses to treatment and impacts on long-term survival

2017 ◽  
Vol 7 (4) ◽  
pp. 348-357 ◽  
Author(s):  
Marten Trendelenburg ◽  
Fabio Stallone ◽  
Kateryna Pershyna ◽  
Timo Eisenhut ◽  
Raphael Twerenbold ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Complement Activation ◽  
Subgroup Analysis ◽  
Potential Role ◽  
Control Group ◽  
Term Survival ◽  
Activation Products

Background: Previous studies have indicated a correlation between heart failure, inflammation and poorer outcome. However, the pathogenesis and role of inflammation in acute heart failure (AHF) is incompletely studied and understood. The aim of our study was to explore the potential role of innate immunity – quantified by complement activation products (CAPs) – in pathophysiology, responses to treatment and impacts on long-term survival in AHF. Methods: In a prospective study enrolling 179 unselected patients with AHF, plasma concentrations of C4d, C3a and sC5b-9 were measured in a blinded fashion on the first day of hospitalisation and prior to discharge. The final diagnosis, including the AHF phenotype, was adjudicated by two independent cardiologists. Long-term follow-up was obtained. Findings in AHF were compared to that obtained in 75 healthy blood donors (control group). Results: Overall, concentrations of all three CAPs were significantly higher in patients with AHF than in healthy controls (all p < 0.001). In an age-adjusted subgroup analysis, significant differences could be confirmed for concentrations of C4d and sC5b-9, and these parameters further increased after 6 days of in-hospital treatment ( p < 0.001). In contrast, C3a levels in AHF patients did not differ from those of the control group in the age-adjusted subgroup analysis and remained constant during hospitalisation. Concentrations of C4d, C3a and sC5b-9 were significantly higher when AHF was triggered by an infection as compared to other triggers ( p < 0.001). In addition, CAP levels significantly correlated with each other ( r = 0.64–0.76), but did not predict death within 2 years. Conclusions: Activation of complement with increased plasma levels of C4d and sC5b-9 at admission and increasing levels during AHF treatment seems to be associated with AHF, particularly when AHF was triggered by an infection. However, CAPs do not have a prognostic value in AHF.

scholarly journals Clinical usefulness of high levels of C-reactive protein for diagnosing epithelial ovarian cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Desheng Yang ◽  
Haini Li ◽  
Xiaoyan Sun ◽  
Shengmei Yang ◽  
Kewei Wang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Control Group ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Cancer Group ◽  
Diagnostic Capability ◽  
Diagnostic Role

AbstractThe purpose of the present study was to evaluate the diagnostic role of CRP in ovarian cancer and to assess whether CRP can be combined with tumor markers to enhance the diagnostic efficacy toward ovarian cancer. Area under the curve, sensitivity, and specificity were calculated to access the diagnostic ability of each singly and combined as markers for ovarian cancer. The CRP cut-off value was then calculated to evaluate the diagnostic efficacy of CRP for ovarian cancer. Our results showed that values for all markers were significantly higher in the cancer group than in the control group. Receiver operating characteristic curve results showed that CA125 had the highest diagnostic efficacy for ovarian cancer, while the sensitivity for CRP was higher than for CA125, and the specificity for CRP was equal to that of CA125. The combination of CRP, CA125, and HE4, however, provided the strongest diagnostic capability. Furthermore, the diagnostic cut-off value for CRP with regard to ovarian cancer was 9.8 mg/L, and high levels of CRP were correlated with stage and tumor size of ovarian cancer. Our study indicated that CRP is valuable in the diagnosis of ovarian cancer, and that combining CRP with CA125 and HE4 improved the diagnostic efficacy with respect to ovarian cancer.

scholarly journals Serum Exosomal MiR-92b-5p as a Potential Biomarker for Acute Heart Failure Caused by Dilated Cardiomyopathy

2018 ◽  
Vol 46 (5) ◽  
pp. 1939-1950 ◽  
Author(s):  
Tao Wu ◽  
Yichen Chen ◽  
Yantao Du ◽  
Jin Tao ◽  
Zhong Zhou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Acute Heart Failure ◽  
Characteristic Curve ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Potential Biomarker ◽  
Spearman’S Correlation

Background/Aims: MicroRNAs (miRNAs) can be used as biomarkers for cardiovascular diseases, especially for heart failure. However, there are few reports on serum exosomal miRNA biomarkers in patients with acute heart failure (AHF) due to Dilated cardiomyopathy (DCM). Methods: We analyzed 3 different serum exosomal miRNAs (exo-miR-92b-5p, exo-miR-192-5p, and exo-miR-320a) in 43 patients with DCM-AHF and 34 healthy volunteers as a control group (CG) by using exosome separation followed by a quantitative reverse-transcript PCR assay. Exosomes were identified by electron microscopy, NaNOZS-90, and western blot analyses (CD63 and Hsp70). Results: Serum exo-miR-92b-5p expression was increased in DCM-AHF patients compared to the CG (Mann–Whitney U-test: P < 0.001). Exo-miR-92b-5p was positively related to age and some ultrasound data (Spearman’s correlation: exo-miR-92b-5p vs. age, r = 0.297, P = 0.014; exo-miR-92b-5p vs. left atrial diameter, r = 0.431, P < 0.001; exo-miR-92b-5p vs. left ventricular diastolic diameter, r = 0.419, P < 0.001; exo-miR-92b-5p vs. left ventricular systolic diameter, r = 0.446, P < 0.001). Exo-miR-92b-5p was also negatively related to other ultrasound data (Spearman’s correlation: exo-miR-92b-5p vs. left ventricular fraction shortening, r = -0.497, P < 0.001; exo-miR-92b-5p vs. left ventricular ejection fraction, r = -0.482, P < 0.001). The discrimination of DCM-AHF patients from the CG by exo-miR-92b-5p was demonstrated by a receiver operating characteristic curve (exo-miR-92b-5p: cutoff value = 0.0023, area under the curve = 0.808, P < 0.001, sensitivity = 62.8%, specificity = 85.3%). Conclusion: Serum exo-miR-92b-5p is a potential biomarker for the diagnosis of DCM-AHF.

Abstract 18883: High Sensitivity Troponin T in Acute Heart Failure: Insights from RELAX-AHF

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
G. Michael Felker ◽  
Robert J Mentz ◽  
J R Teerlink ◽  
A A Voors ◽  
P S Pang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Treatment Effect ◽  
Troponin T ◽  
High Sensitivity ◽  
Adverse Outcomes ◽  
Reference Limit ◽  
High Sensitivity Troponin ◽  
Increased Risk ◽  
High Sensitivity Troponin T

Background: Elevations of cardiac troponin are common in acute heart failure (AHF), but their clinical importance is uncertain. We examined the association between serial high-sensitivity troponin T (hs-cTnT) and outcomes in the RELAX-AHF study, a randomized trial of IV serelaxin in AHF. Methods: hs-cTnT (Roche Diagnostics) was measured at baseline and days 2, 5, and 14. Patients with clinical evidence of ACS were excluded by protocol. 1074 patients (93% of total cohort) with data available for both baseline and at least 1 follow-up hs-cTnT measurement were analyzed. We assessed the relationship between baseline hs-cTnT and peak change from baseline hs-cTnT with outcomes. Models were adjusted for other clinical variables and treatment assignment. Differential effect of serelaxin by troponin levels was assessed by interactions terms. Results: The median baseline troponin was 0.033 mcg/L, and 95% were above the 99 th upper reference limit (URL). Patients with elevated hs-cTnT were more likely to be men with ischemic heart disease, worse renal function, and higher natriuretic peptides. Both higher baseline hs-cTnT and greater peak hs-cTnT were associated with increased risk for adverse outcomes even after adjustment ( Table ). Treatment effect of serelaxin did not differ based on troponin status. Conclusion: Consistent with prior data, hs-cTnT was elevated above the 99% URL in the vast majority of AHF patients at baseline, and was associated with markers of disease severity. Both baseline and peak change from baseline hs-cTnT were associated with worse clinical outcomes, but relationships were generally strongest for 180-day CV mortality. Treatment effect of serelaxin did not differ based on troponin status.

scholarly journals No difference in biomarkers of ischemic heart injury and heart failure in patients with COVID-19 who received treatment with chloroquine phosphate and those who did not

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256035
Author(s):  
Josefine Beck-Friis ◽  
Susannah Leach ◽  
Elmir Omerovic ◽  
Rickard Zeijlon ◽  
Magnus Gisslen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Troponin T ◽  
Ischemic Heart ◽  
Cardiac Biomarkers ◽  
Control Group ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Increased Risk ◽  
Heart Injury ◽  
Biochemical Analyses

Background Chloroquine was promoted as a COVID-19 therapeutic early in the pandemic. Most countries have since discontinued the use of chloroquine due to lack of evidence of any benefit and the risk of severe adverse events. The primary aim of this study was to examine if administering chloroquine during COVID-19 imposed an increased risk of ischemic heart injury or heart failure. Methods Medical records, laboratory findings, and electrocardiograms of patients with COVID-19 who were treated with 500 mg chloroquine phosphate daily and controls not treated with chloroquine were reviewed retrospectively. Controls were matched in age and severity of disease. Results We included 20 patients receiving chloroquine (500 mg twice daily) for an average of five days, and 40 controls. The groups were comparable regarding demographics and biochemical analyses including C-reactive protein, thrombocytes, and creatinine. There were no statistically significant differences in cardiac biomarkers or in electrocardiograms. Median troponin T was 10,8 ng/L in the study group and 17.9 ng/L in the control group, whereas median NT-proBNP was 399 ng/L in patients receiving chloroquine and 349 ng/L in the controls. Conclusions We found no increased risk of ischemic heart injury or heart failure as a result of administering chloroquine. However, the use of chloroquine to treat COVID-19 outside of clinical trials is not recommended, considering the lack of evidence of its effectiveness, as well as the elevated risk of fatal arrythmias.

scholarly journals Use of High-Sensitivity Troponin T to Identify Patients With Acute Heart Failure at Lower Risk for Adverse Outcomes

2016 ◽  
Vol 4 (7) ◽  
pp. 591-599 ◽  
Author(s):  
Peter S. Pang ◽  
John R. Teerlink ◽  
Adriaan A. Voors ◽  
Piotr Ponikowski ◽  
Barry H. Greenberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Lower Risk ◽  
Troponin T ◽  
High Sensitivity ◽  
Adverse Outcomes ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T
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