scholarly journals Plasma Interleukin-6 Level is Associated with NT-proBNP Level and Predicts Short- and Long Term Mortality in Patients with Acute Heart Failure

2010 ◽  
Vol 53 (4) ◽  
pp. 225-228 ◽  
Author(s):  
Radek Pudil ◽  
Miloš Tichý ◽  
Ctirad Andrýs ◽  
Vít Řeháček ◽  
Václav Bláha ◽  
...  
Keyword(s):  
Heart Failure ◽  
Interleukin 6 ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Prognostic Information ◽  
Clinical Covariates ◽  
Short And Long Term ◽  
Long Term Mortality

Objectives: Interleukin 6 plays an important role in chronic heart failure (HF), but little is known about its involvement in acute decompensated heart failure (ADHF). The aim of our study is to evaluate the prognostic role of interleukin 6 (IL-6) in the patients with ADHF. Methods: Plasma levels of interleukin IL-6, N-terminal pro brain natriuretic peptide levels, and clinical covariates were measured in 92 patients with ADHF. Survival was followed up to 12 months, and prognostic factors were evaluated. Results: Elevated plasma IL-6 levels were increased in nonsurvivors and were associated with 1-year mortality (p<0.01). Plasma IL-6 levels were associated with plasma NT-proBNP levels. In multivariate analysis, increased plasma IL-6 and NT-proBNP levels remained strong independent predictors of 1-year mortality. Conclusions: Plasma IL-6 levels provide important prognostic information in the patients with ADHF. Measurement combining plasma IL-6 and NT-proBNP should serve as a powerful prognostic tool of multimarker strategy in patients with acute decompensated heart failure.

scholarly journals Role of Cardiac Troponin Levels in Acute Heart Failure

2015 ◽  
Vol 1 (2) ◽  
pp. 102 ◽  
Author(s):  
Nicholas Wettersten ◽  
Alan Maisel ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Cardiac Troponin ◽  
Acute Decompensated Heart Failure ◽  
Myocardial Necrosis ◽  
Decompensated Heart Failure ◽  
Readmission Rates ◽  
Coronary Syndrome ◽  
Short And Long Term

Cardiac troponin (cTn) is the primary biomarker for the diagnosis of myocardial necrosis in an acute coronary syndrome (ACS). cTn levels can also be elevated in many other conditions, including heart failure, with significant prognostic value. An elevated cTn level can be found in both acute and chronic heart failure and its presence is believed to be due to multiple different pathophysiological processes. In acute decompensated heart failure (AHF), an elevated cTn level has been repeatedly shown to correlate with increased short- and long-term mortality and, to a lesser extent, readmission rates. These associations have been demonstrated with both I and T isoforms of cTn, as well as when troponin is measured with conventional assays or new high-sense assays. In multimarker models, cTn has repeatedly been found to be an independent predictive variable enhancing prognostic ability of the model. cTn is therefore an important biomarker for prognosis in AHF.

scholarly journals Long-term mortality in older patients discharged after acute decompensated heart failure: a prospective cohort study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Pierre-André Natella ◽  
Philippe Le Corvoisier ◽  
Elena Paillaud ◽  
Bertrand Renaud ◽  
Isabelle Mahé ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Older Patients ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Long Term Mortality

Abstract 12660: Model of End-Stage Liver Disease Excluding INR (MELD-XI) Scoring System Provides the Long-Term Prognostic Information in Patients Admitted With Acute Decompensated Heart Failure, Regardless of Reduced or Preserve Left Ventricular Ejection Fraction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Scoring System ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prognostic Information ◽  
Ventricular Ejection Fraction ◽  
Cox Analysis

Backgrounds: Liver dysfunction has a prognostic impact on the outcome of patients with advanced heart failure. A model of end-stage liver disease excluding INR (MELD-XI) is a robust scoring system of liver dysfunction, and a high score has been shown to be associated with poor prognosis in patients with heart failure. However, there is little information available on the long-term prognostic significance of MELD-XI score in patients admitted with acute decompensated heart failure (ADHF), relating to reduced or preserved left ventricular ejection fraction (HFrEF or HFpEF). Methods and Results: We studied 303 consecutive patients admitted with ADHF and discharged with survival (HFrEF(LVEF<50%); n=163, HFpEF;n=140). MELD-XI score was calculated by the following formula: 5.11[[Unable to Display Character: &#65381;]]ln(bilirubin)+11.79[[Unable to Display Character: &#65381;]]ln(creatinine)+9.44. During a follow-up period of 5.0±4.3 yrs, 75 patients had cardiovascular death (CVD). Receiver-operator curve analysis revealed that MELD-XI score of 12 was a fair discriminator for CVD (AUC 0.704 (95%CI 0.635-0.772), p<0.0001; sensitivity 67% and specificity 62%). In HFrEF group, MELD-XI score was significantly independently associated with CVD (p=0.0037) at multivariate Cox analysis, and patients with high MELD-XI score (≥12) had a higher risk of CVD than those with low MELD score (46% vs 24%, p=0.0038, hazard ratio: 2.20 (95%CI 1.27-3.79)). In HFpEF group, MELD-XI score was also significantly independently associated with CVD (p=0.005) at multivariate Cox analysis, and patients with high MELD-XI score (≥12) had a higher risk of CVD (34% vs 8%, p<0.0001, hazard ratio: 6.25 (95%CI 2.59-15.05)). Conclusion: A MELD-XI scoring system would provide the long-term prognostic information in patients admitted with ADHF, regardless of HFrEF or HFpEF.

Abstract 12854: Uric Acid In-hospital Change Provides the Additional Long-Term Prognostic Information to Acute Kidney Injury in Patients Admitted for Acute Decompensated Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Acute Decompensated Heart Failure ◽  
Kidney Injury ◽  
Fold Increase ◽  
Decompensated Heart Failure ◽  
Cvd Risk ◽  
Prognostic Information ◽  
Stage 1

Backgrounds: Acute kidney injury (AKI) during heart failure treatment is associated with poor outcome in patients admitted with acute decompensated heart failure (ADHF). In patients with ADHF,increased uric acid (UA) level is also a prognostic marker, but there is no information available on the long-term prognostic significance of UA in-hospital change, relating to AKI in patients admitted for ADHF. Methods and Results: We studied 237 patients admitted with ADHF and discharged with survival. The measurements of serum UA and creatinine (Cr) levels were repeated during hospitalization, and the change of UA was obtained by subtracting the value at admission or discharge from the maximum value. AKI was defined according to AKI Network criteria (stage 1, ≥0.3mg/dl absolute or 1.5-to 2.0-fold relative increase in Cr; stage 2, >2- to 3-fold increase in Cr; stage 3, >3-fold increase in Cr or Cr≥4.0mg/dl with an acute rise of ≥0.5mg/dl). During a follow-up period of 4.3±3.3 yrs, 59 patients had cardiovascular death (CVD). At multivariate Cox analysis, UA change (p=0.02) and stage 2 or 3 AKI (p=0.01) were significantly associated with CVD, independently of age, systolic blood pressure, serum sodium, hemoglobin, UA and Cr levels, although stage 1 AKI showed no significant association with CVD. Patients with both higher degree of UA change (top quartile:≥4.4 mg/dl) and stage 2 or 3 AKI had a significant increased CVD risk, compared to patients with either higher UA change or stage 2 or 3 AKI (75% vs 34%, p=0.006, hazard ratio 3.8[95%CI 1.4-8.6]). Furthermore, patients with either higher UA change or stage 2 or 3 AKI also had a significant increased CVD risk, compared to patients with none of these two variables (34% vs 19%, p=0.01, hazard ratio 2.0[95%CI 1.1-3.5]). Conclusion: Uric acid in-hospital change could provide the additional long-term prognostic information to moderate to severe AKI in patients admitted for ADHF.

Abstract 12975: A New Systemic Inflammation-nutrition Index Provides the Additional Long-term Prognostic Information to Ahead Score in Patients With Admitted for Acute Decompensated Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Testuya Watanabe ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Systemic Inflammation ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Prognostic Information ◽  
Heart Failure Patients ◽  
Ahead Score

Background: Comorbidities are associated with poor clinical outcome in heart failure patients. AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes in patients with acute decompensated heart failure (ADHF). On the other hand, systemic inflammation plays a critical role in the outcomes of heart failure. Malnutrition is also associated with poor outcome in heart failure patients. It has been recently reported that advanced lung cancer inflammation index (ALI), which is calculated as body mass index х serum albumin / neutrophil to lymphocyte ratio, is an independent prognostic marker in several types of cancer. We sought to investigate the prognostic value of the combination of AHEAD score and ALI in ADHF patients. Methods and Results: We studied 263 patients admitted for ADHF and discharged with survival. At the discharge, we obtained ALI and AHEAD score (range 0-5, atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus). During a follow-up period of 5.0±4.2 yrs, 67 patients had cardiovascular death (CVD). At multivariate Cox analysis, AHEAD score and ALI were significantly independently associated with CVD, independently of prior heart failure hospitalization, systolic blood pressure and serum sodium level. The patients with both greater AHEAD score (≥median value=3) and lower ALI (≤median value=42.3) had a significantly increased risk of CVD than those with either and none of them (45% vs 24% vs 13%, p<0.0001, respectively). Conclusion: ALI would provide the additional long-term prognostic information to AHEAD score in patients with ADHF.

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