Abstract 11405: The Association of Co-Morbid Symptoms of Depression and Anxiety With All-Cause Mortality in Patients With Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Abdullah Alhurani ◽  
Rebecca Dekker ◽  
Mona Abed ◽  
Amani Khalil ◽  
Kyoung Suk Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cox Regression ◽  
Brief Symptom Inventory ◽  
Categorical Variables ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cox Regression Analysis ◽  
Symptoms Of Depression ◽  
All Cause Mortality

Introduction: Depression or anxiety are associated with survival in heart failure (HF); however, whether co-morbid symptoms of anxiety and depression are associated with survival in patients with HF is unknown. Hypothesis: Co-morbid symptoms of depression and anxiety are more strongly associated with all-cause mortality in patients with HF compared to those with anxiety or depression alone. Methods: A total of 1,260 HF patients participated and were followed for mortality outcomes for 12 months. The Patient Health Questionnaire (PHQ-9) and Brief Symptom Inventory-anxiety subscale (BSI) were used to measure symptoms of depression and anxiety. Cox regression analysis was used to determine whether co-morbid symptoms of depression and anxiety independently predicted all-cause mortality controlling for age,gender, ethnicity, and NYHA class. Depression and anxiety were treated first as continuous level variables, then as categorical variables using standard published cut points. Patients were divided into four groups based on the presence of anxiety and depression symptoms: 1) neither anxiety nor depression, 2) depression alone, 3) anxiety alone, and 4) co-morbid depression and anxiety Results: When entered as continuous variables, the interaction between anxiety and depression (HR 1.02; 95% CI: 1.01-1.03; p = 0.002) was a significant predictor of all-cause mortality. When entered as a categorical variable, co-morbid symptoms of depression and anxiety (versus the other three groups) independently predicted all-cause mortality (HR 2.59; 95% CI: 1.49-4.49; p = 0.001). Conclusions: To improve mortality outcomes in patient with HF, attention must be paid by healthcare providers to the assessment and management of co-morbid symptoms of depression and anxiety.

P1885Cha2ds-2vasc score lacks of ability to predict mortality in patients attending the emergency department with atrial fibrillation in the presence of troponin i

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M I Gonzalez Del Hoyo ◽  
G Cediel ◽  
A Carrasquer ◽  
G Bonet ◽  
K Vasquez-Nunez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Emergency Department ◽  
Regression Analysis ◽  
Troponin I ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Abstract Background CHA2DS2-VASc score has been used as a surrogate marker for predicting outcomes beyond thromboembolic risk in patients with atrial fibrillation (AF). Likewise, cardiac troponin I (cTnI) is a predictor of mortality in AF. Purpose This study aimed to investigate the association of cTnI and CHA2DS2-VASc score with long-term prognosis in patients admitted to the emergency department with AF. Methods A retrospective cohort study conducted between January 2012 and December 2013, enrolling patients admitted to the emergency department with AF and having documented cTnI measurements. CHA2DS2-VASc score was estimated. Primary endpoint was 5-year all-cause mortality, readmission for heart failure (HF), readmission for myocardial infarction (MI) and the composite end point of major adverse cardiac events defined as death, readmission for HF or readmission for MI (MACE). Results A total of 578 patients with AF were studied, of whom 252 patients had elevated levels of cTnI (43.6%) and 334 patients had CHA2DS2-VASc score >3 (57.8%). Patients with elevated cTnI tended to be oldercompared with those who did not have cTnI elevation and were more frequently comorbid and of higher ischemic risk, including hypertension, prior MI, prior HF, chronic renal failure and peripheral artery disease. The overall median CHA2DS2-VASc score was higher in those with cTnI elevation compared to those patients elevated cTnI levels (4.2 vs 3.3 points, p<0.001). Main diagnoses at hospital discharge were tachyarrhythmia 30.3%, followed by heart failure 17.7%, respiratory infections 9.5% and acute coronary syndrome 7.3%. At 5-year follow-up, all-cause death was significantly higher for patients with cTnI elevation compared with those who did not have cTnI elevation (56.4% vs. 27%; logrank test p<0.001). Specifically, for readmissions for HF and readmissions for MI there were no differences in between patients with or without cTnI elevation. In addition, MACE was reached in 165 patients (65.5%) with cTnI elevation, compare to 126 patients (38.7%) without cTnI elevation (p<0.001). On multivariable Cox regression analysis, cTnI elevation was an independent predictor of all-cause death (hazard ratio, 1.67, 95% confidence interval [CI]: 1.24–2.26, p=0.001) and of MACE (hazard ratio 1.47, 95% confidence interval 1.15–1.88; P=0.002), but it did not reach statistical significance for readmissions for MI and readmissions for HF. CHA2DS2-VASc score was a predictor on univariate Cox regression analysis for each endpoint, but it did not reach significance on multivariable Cox regression analysis for any endpoint. Conclusions cTnI is independently associated with long-term all-cause mortality in patients attending the emergency department with AF. cTnI compared to CHA2DS2-VASc score is thus a biomarker with predictive capacity for mortality in late follow-up, conferring utility in the risk stratification of patients with atrial fibrillation.

Symptoms of Anxiety and Depression Among Teens and Adults in the Thalassemia Longitudinal Cohort Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 555-555
Author(s):  
Lauren Mednick ◽  
Shuli Yu ◽  
Felicia Trachtenberg ◽  
Dorothy A. Kleinert ◽  
Patricia J Giardina ◽  
...  
Keyword(s):  
Research Funding ◽  
Well Being ◽  
Functional Health ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Chronic Medical Conditions ◽  
Depression And Anxiety ◽  
Medical Conditions ◽  
Symptoms Of Depression ◽  
Health And Well Being

Abstract Abstract 555 Background and Significance: Individuals with chronic medical conditions are vulnerable to symptoms of anxiety and depression. Promoting healthy emotional functioning is important not only to psychological well-being, but also to physical health as it has been shown to impact adherence to medical regimens. Thalassemia is an inherited blood disorder which requires lifelong intervention and may be associated with treatment and disease-related complications that impact both the length and quality of life for most who are affected. While several studies have examined the prevalence of anxiety and depressive symptoms in patients with thalassemia, most have been conducted with small, homogeneous samples of children. In addition, the one study which examined psychological adjustment in adults included patients from only one medical center (Messina et al.; Intern Emerg Med, 3:339, 2008). Further, few studies have examined demographic, medical, and psychosocial variables possibly correlated with the occurrence of these symptoms. Understanding the factors that are related to the experience of depressive and anxiety symptoms may help us to identity individuals at risk and help in developing targeted interventions. The current study aimed to (1) determine the prevalence of depressive and anxiety symptoms in adolescent and adult patients with thalassemia; and (2) explore possible demographic, medical, and psychosocial correlates of these symptoms. Specifically, we hypothesized that (1) anxiety and depressive symptoms in this sample would be similar to the rates of these symptoms in individuals diagnosed with other chronic medical conditions and higher than in individuals without chronic medical conditions; (2) symptoms of depression and anxiety would be inversely correlated with measures of adherence (i.e., subjective report, ferritin); and (3) symptoms of depression and anxiety would be inversely correlated with functional health and well-being. Method: Data on quality of life and mental health self assessments were collected as part of the Thalassemia Longitudinal Cohort (TLC), a multi-center multinational study conducted by the NHLBI-sponsored Thalassemia Clinical Research Network. The current analysis included 281 participants (14-58 years old, M age=27.83; 52% female) who completed the Hospital Anxiety and Depression Scale (HADS), a 14-item questionnaire examining presence of anxiety and depression symptoms. Participants also completed a measure of functional health and well-being (SF-36), as well as questions related to adherence to their medical regimen. In addition, as part of the larger TLC study, medical data such as ferritin and method of chelation was collected. Results: 32% of participants indicated experiencing at least mild symptoms of anxiety and 11% at least mild symptoms of depression. While these rates are higher than rates of symptoms of depression and anxiety found in the general population, they are similar to rates found in other groups with chronic illness (e.g., diabetes). Older age, female gender, and chelation with deferoxamine (as compared to deferasirox) were factors that were significantly associated with anxiety and/or depression and were statistically controlled for in subsequent analyses. Symptoms of depression, but not anxiety, were inversely correlated with subjective reports of adherence (p<.05), although not with ferritin levels. However, a significant correlation in the expected direction between subjective report of adherence and ferritin was found (p<.01). Finally, as hypothesized, both symptoms of depression and anxiety were significantly and negatively correlated with functional health and well-being (p<.0001). Conclusion: While the majority of patients with thalassemia do not report significant symptoms of anxiety and depression, the rates are higher than in the general population. Given that symptoms of anxiety and depression were associated with poor adherence and lower functional health and well-being, regular screening for anxiety and depression symptoms could help to identify at risk individuals in order to provide them with appropriate psychological support with the goal of improving both emotional and physical health. Disclosures: Porter: Novartis: Research Funding. Thompson:Novartis: Research Funding. Neufeld:Novartis: Research Funding.

scholarly journals High Plasma Docosahexaenoic Acid Associated to Better Prognoses of Patients with Acute Decompensated Heart Failure with Preserved Ejection Fraction

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 371
Author(s):  
Naoaki Matsuo ◽  
Toru Miyoshi ◽  
Atsushi Takaishi ◽  
Takao Kishinoue ◽  
Kentaro Yasuhara ◽  
...  
Keyword(s):  
Heart Failure ◽  
Docosahexaenoic Acid ◽  
Ejection Fraction ◽  
Primary Outcome ◽  
Cox Regression ◽  
Risk Index ◽  
Preserved Ejection Fraction ◽  
Cox Regression Analysis ◽  
Nutritional Risk Index ◽  
All Cause Mortality

The clinical relevance of polyunsaturated fatty acids (PUFAs) in heart failure remains unclear. The aim of this study was to investigate the association between PUFA levels and the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). This retrospective study included 140 hospitalized patients with acute decompensated HFpEF (median age 84.0 years, 42.9% men). The patients’ nutritional status was assessed, using the geriatric nutritional risk index (GNRI), and their plasma levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-gamma-linolenic acid (DGLA) were measured before discharge. The primary outcome was all-cause mortality. During a median follow-up of 23.3 months, the primary outcome occurred in 37 patients (26.4%). A Kaplan–Meier analysis showed that lower DHA and DGLA levels, but not EPA or AA levels, were significantly associated with an increase in all-cause death (log-rank; p < 0.001 and p = 0.040, respectively). A multivariate Cox regression analysis also revealed that DHA levels were significantly associated with the incidence of all-cause death (HR: 0.16, 95% CI: 0.06–0.44, p = 0.001), independent of the GNRI. Our results suggest that low plasma DHA levels may be a useful predictor of all-cause mortality and potential therapeutic target in patients with acute decompensated HFpEF.

scholarly journals Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseba Wulff ◽  
Agneta Malmgren Fänge ◽  
Connie Lethin ◽  
Carlos Chiatti
Keyword(s):  
Informal Caregivers ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
People With Dementia

Abstract Background Around 50 million people worldwide are diagnosed with dementia and this number is due to triple by 2050. The majority of persons with dementia receive care and support from their family, friends or neighbours, who are generally known as informal caregivers. These might experience symptoms of depression and anxiety as a consequence of caregiving activities. Due to the different welfare system across European countries, this study aimed to investigate factors associated with self-reported depression and anxiety among informal dementia caregivers both in Sweden and Italy, to ultimately improve their health and well-being. Methods This comparative cross-sectional study used baseline data from the Italian UP-TECH (n = 317) and the Swedish TECH@HOME (n = 89) studies. Main outcome variables were the severity of self-reported anxiety and depression symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). HADS scores were investigated using descriptive and bivariate statistics to compare means and standard deviations. Linear regressions were used to test for associations between potential factors and self-reported symptoms of depression and anxiety. Results Italian informal caregivers reported more severe symptoms of depression and anxiety than Swedish caregivers. In Italy, a higher number of hours of caregiving was associated with anxiety symptoms (β = − 1.205; p = 0.029), being 40–54 years-old with depression symptoms (β = − 1.739; p = 0.003), and being female with symptoms of both depression (β = − 1.793; p < 0.001) and anxiety (β = 1.474; p = 0.005). In Sweden, a higher number of hours of caregiving and being < 39 years-old were associated with depression symptoms (β = 0.286; p < 0.000; β = 3.945; p = 0.014) and a higher number of hours of caregiving, the lack of additional informal caregivers and dementia severity were associated with anxiety symptoms (β = 0.164; p = 0.010; β = − 1.133; p = 0.033; β = − 1.181; p = 0.031). Conclusion Multiple factors are associated with self-reported symptoms of depression and anxiety among informal caregivers in Sweden and Italy. Factors found in this study partly differ between the two countries, suggesting the important role of cultural and social factors affecting the experience of caregiving. A deeper knowledge of these factors may increase the knowledge on potential protective and risk factors, provide information to policymakers and ultimately improve the psychological well-being of informal caregivers to people with dementia across Europe.

scholarly journals The Association of Co-morbid Symptoms of Depression and Anxiety With All-Cause Mortality and Cardiac Rehospitalization in Patients With Heart Failure

2015 ◽  
Vol 56 (4) ◽  
pp. 371-380 ◽  
Author(s):  
Abdullah S. Alhurani ◽  
Rebecca L. Dekker ◽  
Mona A. Abed ◽  
Amani Khalil ◽  
Marwa H. Al Zaghal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Patients With Heart Failure ◽  
All Cause Mortality

scholarly journals Symptoms of Anxiety and Depression Modulate the Recognition of Facial Emotion

2017 ◽  
Vol 16 (4) ◽  
pp. 1 ◽  
Author(s):  
Natália Mendes Ferrer da Rosa ◽  
Vinícius Ferreira Borges ◽  
Leonardo Cheffer ◽  
Nelson Torro Alves ◽  
Célio Estanislau
Keyword(s):  
Trait Anxiety ◽  
State Anxiety ◽  
Clinical Sample ◽  
Facial Emotion ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Experimental Task ◽  
Symptoms Of Depression ◽  
Neutral Face

Previous studies have shown that depression and anxiety are associated to changes in the recognition of facial expression. In the present research, a non-clinical sample was evaluated with respect to trait and state anxiety and depression symptoms. In the experimental task, participants evaluated facial expressions of happiness, anger, sadness, and fear, presented at four intensities (25, 50, 75, and 100%), as well as the neutral face. Results showed that the trait anxiety was associated with a better recognition of anger, fear, and happiness. For depression, we only found differences between groups for emotional attribution to neutral faces, in which participants scoring high in depression were more likely to attribute fear to neutral faces. Findings indicate an improvement of the recognition of happiness, anger, and fear in trait anxiety, whereas symptoms of depression and state anxiety were associated to changes in the evaluation of neutral faces in non-clinical individuals.

scholarly journals Assessing Changes in Symptoms of Depression and Anxiety During Four Weeks of Cannabis Abstinence Among Adolescents

2021 ◽  
Vol 12 ◽  
Author(s):  
Megan E. Cooke ◽  
Jodi M. Gilman ◽  
Erin Lamberth ◽  
Natali Rychik ◽  
Brenden Tervo-Clemmens ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Contingency Management ◽  
Negative Mood ◽  
Cannabis Use ◽  
Self Report ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Significant Symptom

Background: Cannabis use is prevalent among adolescents, and many report using in attempts to alleviate negative mood and anxiety. Abstinence from substances such as alcohol and tobacco has been reported to improve symptoms of anxiety and depression. Few studies have examined the effect of cannabis abstinence on symptoms of anxiety and depression.Objective: To test the effect of 4 weeks of continuous cannabis abstinence on depressive and anxious symptoms.Methods: Healthy, non-treatment seeking adolescents who used cannabis at least weekly (n = 179) were randomized to either 4 weeks of cannabis abstinence achieved through a contingency management paradigm (CB-Abst) or cannabis use monitoring without an abstinence requirement (CB-Mon). Abstinence was assessed by self-report verified with quantitative assay of urine for cannabinoids. Anxiety and depressive symptoms were assessed weekly with the Mood and Anxiety Symptom Questionnaire (MASQ).Results: Symptoms of depression and anxiety decreased throughout the study for all participants (MASQ-AA: stnd beta = −0.08, p = 0.01, MASQ-GDA: stnd beta = −0.11, p = 0.003, MASQ-GDD: stnd beta = −0.08, p = 0.02) and did not differ significantly between randomization groups (p's &gt; 0.46). Exploratory analyses revealed a trend that abstinence may be associated with greater improvement in symptoms of anxiety and depression among those using cannabis to cope with negative affect and those with potentially hazardous levels of cannabis use.Conclusions: Among adolescents who use cannabis at least weekly, 4 weeks of cannabis abstinence was not associated with a significant change in anxiety or depressive symptoms compared to continued use. For recreational cannabis users who may be concerned about reducing their use for fear of increased symptoms of anxiety and depression, findings suggest that significant symptom worsening may not occur within the first 4 weeks of abstinence. Further studies are needed in clinical populations where anxiety and depression symptoms are measured more frequently and for a longer period of abstinence. Future studies are also needed to determine whether there are subgroups of adolescents who are uniquely impacted by sustained cannabis abstinence.

scholarly journals Symptoms of depression at discharge after PCI are associated with an increased risk of 1-year mortality: findings from the national DenHeart study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Borregaard ◽  
S.N Nielsen ◽  
J.F Lassen ◽  
L.O Jensen ◽  
L Thrysoe ◽  
...  
Keyword(s):  
Mental Health ◽  
Depression Scale ◽  
Adverse Outcomes ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Although survival rates among patients with coronary artery disease have increased since the introduction of treatment with percutaneous coronary intervention, PCI, the effect of psychological factors such as symptoms of anxiety and depression on adverse outcomes are sparsely described. Purpose The objective of the current study was to investigate the association between symptoms of anxiety and depression and 1-year mortality after PCI. Methods A national cross-sectional survey at hospital discharge (responders, n=3,366) with register-based follow-up among patients having undergone elective or emergency PCI. Mental health was measured using the Hospital Anxiety and Depression Scale, HADS, and divided into symptoms of anxiety (HADS-A) and symptoms of depression (HADS-D). The association between mental health (HADS-A and HADS-D) and 1-year all-cause mortality were investigated with Cox Proportional Hazard models with time to death as the underlying time scale. The results are presented as hazard ratios (HR) with 95% confidence intervals (CI) and adjusted for sex, age and Tu-comorbidity score. Results At discharge, 32% of the population reported symptoms of anxiety (HADS-A ≥8) and 19% reported symptoms of depression (HADS-D ≥8). After one year, the mortality rate among patients being alive at discharge was 2.1%. All-cause mortality did not differ among patients reporting symptoms of anxiety compared to patients without symptoms of anxiety (2.3% vs 1.9%, p=0.454), whereas all-cause mortality was higher among patients reporting symptoms of depression compared to those, who did not (4.3% vs 1.6%, p≤0.001). In the regression analyses, symptoms of anxiety (HADS-A ≥8) was not associated with 1-year mortality (HR 1.16 95% CI 0.70–1.92); however, symptoms of depression was (HADS-D ≥8, HR 2.27 95% CI 1.38–3.73, adjusted analyses). Based on the continuous scores of HADS-D, a one-point increase in scores was associated with a 12% higher risk of 1-year mortality (HR 1.12 95% CI 1.05–1.18) (Figure 1). Conclusion After PCI, nearly one-third of patient report symptoms of anxiety and one-fifth symptoms of depression. Symptoms of anxiety was not associated with 1-year mortality, whereas symptoms of depression increased the risk of 1-year mortality. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Anxiety, stress and depression in family members of patients with heart failure

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Marianna Sobral Lacerda ◽  
Melissa Alves Cirelli ◽  
Alba Lúcia Bottura Leite de Barros ◽  
Juliana de Lima Lopes
Keyword(s):  
Heart Failure ◽  
Family Income ◽  
Family Members ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Patients With Heart Failure ◽  
The Relationship

Abstract OBJECTIVE Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failure; identifying the relationship between these feelings with sociodemographic and clinical variables. METHOD A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. RESULTS Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. CONCLUSION Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression.

N-acetyl-ß-D-glucosaminidase is predictive of mortality in chronic heart failure: a 10-year follow-up

2021 ◽  
Author(s):  
Christina Strack ◽  
Susanne Bauer ◽  
Ute Hubauer ◽  
Ekrem Ücer ◽  
Christoph Birner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cox Regression ◽  
Kidney Injury ◽  
Blood Samples ◽  
Cox Regression Analysis ◽  
All Cause Mortality ◽  
Long Term Follow Up

Aim: The study focused on biomarkers of kidney injury as predictors of mortality in patients with chronic heart failure (CHF) in a long-term follow-up (median 104 months). Methods/results: KIM-1, NAG and NGAL were assessed from urine, NT-proBNP from blood samples. 149 patients (age 62 ± 12 years) with CHF (mean EF 30% [IQR 24–40%]) were enrolled. 79 (53%) patients died. Cox regression analysis revealed Log2NAG (HR: 1.46, CI: 1.12–1.89), Log2KIM-1 (HR: 1.23, CI: 1.02–1.49) and Log2NT-proBNP (HR: 1.50, CI: 1.32–1.72) as significant predictors of all-cause mortality as opposed to Log2NGAL (HR: 1.04, CI: 0.90–1.20). Log2NAG remained a significant predictor of all-cause mortality in a multivariate Cox regression model but lost its predictive value in combination with Log2NT-proBNP. Conclusion: The 10-year follow-up suggests NAG as a predictive tubular marker in CHF patients.

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