scholarly journals Low-Level Elevations of Procalcitonin Are Associated with Increased Mortality in Acute Heart Failure Patients, Independent of Concomitant Infection

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1429
Author(s):  
Fabrice F. Darche ◽  
Moritz Biener ◽  
Matthias Müller-Hennessen ◽  
Rasmus Rivinius ◽  
Kiril M. Stoyanov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Mortality Prediction ◽  
University Hospital ◽  
Operating Characteristics ◽  
Cutoff Value ◽  
Low Level ◽  
Kaplan Meier ◽  
Receiver Operating Characteristics Curve

We aimed to evaluate the prognostic value of procalcitonin (PCT) in acute heart failure (AHF) patients, especially in those without underlying infection. We enrolled patients presenting with acute dyspnea to the emergency department (ED) of Heidelberg University Hospital and studied the prognostic role of PCT on all-cause death. Of 312 patients, AHF was diagnosed in 139 patients. Of these, 125 patients had AHF without signs of infection, and 14 had AHF complicated by respiratory or other infection. The optimal prognostic PCT cutoff value for mortality prediction was calculated by a receiver operating characteristics curve. In patients with AHF, the prognostic PCT cutoff value was 0.08 ng/mL. The Kaplan–Meier survival analysis showed that AHF patients with PCT values > 0.08 ng/mL had a higher all-cause mortality at 120 days than those with PCT values ≤ 0.08 ng/mL (log-rank p = 0.0123). Similar results could be obtained after subdivision into AHF patients with and without signs of overt infection. In both cases, mortality was higher in patients with PCT levels above the prognostic PCT cutoff than in those with values ranging below this threshold. Moreover, we show that the prognostic PCT cutoff values for mortality prediction ranged below the established PCT cutoff for the guidance of antibiotic therapy. In conclusion, the data of our study revealed that low-level elevations of PCT were associated with an increased mortality in patients with AHF, irrespective of concomitant respiratory or other infection. PCT should thus be further used as a marker in the risk stratification of AHF.

scholarly journals Differences in clinical and prognosis patient's characteristics between acute heart failure with mid-range ejection fraction compared to heart failure with other ejection fraction groups

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Gorriz Magana ◽  
M.J Espinosa Pascual ◽  
R Olsen Rodriguez ◽  
R Abad Romero ◽  
C Perela Alvarez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Demographic Data ◽  
University Hospital ◽  
Main Diagnosis ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Moment

Abstract Background There are scarce data on clinical profile and prognosis of pts with Heart failure with mid-range ejection fraction (HFmrEF). The aim of this study was to analyse the patient's characteristics and their prognosis in terms of morbidity and mortality compared to those patients with acute heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fraction Methods We performed a retrospective analysis from a prospective observational study developed in a University Hospital, which covers 220.000 individuals. We analysed 600 discharges with the main diagnosis of Heart Failure with 52 months of median follow up. We obtain clinical and demographic data at the moment of admission and during de follow up. To analyse mortality and readmission we used a Kaplan-Meier model. Results A total of 551 patients (91%) had a transthoracic echocardiogram (TEE) during the admission. Eleven percent (11.8%) of the patients (pts) had HFmrEF (35.6% of them were women), 66.7% HFpEF (81.8% women) and 20.6% HFrEF (29.0% women). Median age of HFmrEF was 80.5±1.3 years, similar to HFpEF (81±0.5 years). However, pts with HFrEF were younger (75.2±1.1 years). A higher percent of pts with HFrEF were on beta-blocker (BB) treatment at admission compared to HFmrEF (51.79% vs 47.54%) and HFpEF (39.91%). At discharge, all of them were on high doses of BB (64.55% HFrEF, 54.10% HFmrEF and 33.62% HFpEF). After an adjusted analysis by age, pts with HFmrEF had higher mortality compared to HEpEF (HR: 0.55; 95% CI: 0.38–0.80; p=0.002) with no statically significant difference compared to HFrEF (HR: 0.88; 95% IC: 0.57–1.35; p=0.5). Pts with HFmrEF were on a higher risk of readmission compared to HFpEF (HR 0.59; 95% CI 0.41–0.84, p=0.004). There was also no statistical difference compared to HFrEF (HR 0.72, 95% CI 0.47–1.11; p=0.14). Conclusions According to our results, pts with HFmrEF and HFpEF are older compared to HFrEF. HFpEF were mostly women, compared to other groups. A lower percent of HFmrEF were also on BB treatment. HFmrEF and HFrEF had a similar prognosis in terms of readmission and mortality. HFmrEF pts were on higher risk of mortality and readmission compared to HFpEF. We need more studies to find more information and confirm these results. Graph 1 Funding Acknowledgement Type of funding source: None

588 The prognostic role of anemia in acute heart failure. Data from the Italian survey on acute heart failure

2006 ◽  
Vol 5 (1) ◽  
pp. 134-134
Author(s):  
L SCELSI ◽  
L TAVAZZI ◽  
A MAGGIONI ◽  
D LUCCI ◽  
G CACCIATORE ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Prognostic Role ◽  
Failure Data ◽  
Italian Survey

Assessment of acute heart failure prognosis: the promising role of prognostic models and biomarkers

2021 ◽  
Author(s):  
Nikolaos P. E. Kadoglou ◽  
John Parissis ◽  
Apostolos Karavidas ◽  
Ioannis Kanonidis ◽  
Marialena Trivella
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Prognostic Models ◽  
Failure Prognosis

scholarly journals Interleukin-6 Could Be a Potential Prognostic Factor in Ambulatory Elderly Patients with Stable Heart Failure: Results from a Pilot Study

2021 ◽  
Vol 10 (3) ◽  
pp. 504
Author(s):  
Marina Povar-Echeverría ◽  
Pablo Esteban Auquilla-Clavijo ◽  
Emmanuel Andrès ◽  
Francisco Javier Martin-Sánchez ◽  
María Victoria Laguna-Calle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Renal Failure ◽  
Interleukin 6 ◽  
Kaplan Meier ◽  
Patients With Heart Failure ◽  
Potential Prognostic Factor ◽  
Fundamental Phenomenon ◽  
Group 2

Introduction: Inflammation is a fundamental phenomenon in heart failure, but the prognostic or therapeutic role of markers such as interleukin-6 (IL-6) has not yet been clarified. The objective of this study is to describe the clinical profile of patients with elevated IL-6 and determine if they have worse clinical outcomes. Methods: A retrospective c.ohort observational study including 78 patients with heart failure followed up at the Heart Failure Outpatient Clinic of the Internal Medicine Department. IL-6 was determined in all patients, who were then assigned into two groups according to IL-6 level (normal or high). Clinical and prognostic data were collected to determine the differences in both groups. Results: The average age was 79 years, 60% female. A total of 53.8% of the patients had elevated IL-6 (group 2). Patients with elevated IL-6 presented more frequently with anemia mellitus (64.3% vs. 41.7%; p = 0.046), atrial fibrillation (83.3% vs. 61.9% p = 0.036), dyslipidemia (76.2% vs. 58.2%; p = 0.03), higher creatinine levels (1.35 mg/dL vs. 1.08 mg/dL; p = 0.024), lower glomerular filtration rate (43.6 mL/min/m2 vs. 59.9 mL/min/m2; p = 0.007), and anemia 25% vs. 52.4% p = 0.014. The factors independently associated with the increase in IL-6 were anemia 3.513 (1.163–10.607) and renal failure 0.963 (0.936–0.991), p < 0.05. Mortality was higher in the group with elevated IL-6 levels (16% vs. 2%; p = 0.044) with a log-rank p = 0.027 in the Kaplan–Meier curve. Conclusion: Patients with heart failure and elevated IL-6 most often have atrial fibrillation, diabetes mellitus, dyslipidemia, anemia, and renal failure. In addition, mortality was higher and a tendency of higher hospital admission was observed in stable HF patients with elevated IL-6.

Evaluation of a multimarker panel in chronic heart failure: a 10-year follow-up

2021 ◽  
Author(s):  
Susanne Bauer ◽  
Christina Strack ◽  
Ekrem Ücer ◽  
Stefan Wallner ◽  
Ute Hubauer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Role ◽  
Blood Samples ◽  
Kaplan Meier ◽  
Risk Of Mortality ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Long Time

Aim: We assessed the 10-year prognostic role of 11 biomarkers with different pathophysiological backgrounds. Materials & methods/results: Blood samples from 144 patients with heart failure were analyzed. After 10 years of follow-up (median follow-up was 104 months), data regarding all-cause mortality were acquired. Regarding Kaplan–Meier analysis, all markers, except TIMP-1 and GDF-15, were significant predictors for all-cause mortality. We created a multimarker model with nt-proBNP, hsTnT and IGF-BP7 and found that patients in whom all three markers were elevated had a significantly worse long-time-prognosis than patients without elevated markers. Conclusion: In a 10-year follow-up, a combination of three biomarkers (NT-proBNP, hs-TnT, IGF-BP7) identified patients with a high risk of mortality.

scholarly journals The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion

2016 ◽  
Vol 218 ◽  
pp. 150-157 ◽  
Author(s):  
Markku S. Nieminen ◽  
Michael Buerke ◽  
Alain Cohen-Solál ◽  
Susana Costa ◽  
István Édes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Acute Heart Failure ◽  
Expert Consensus ◽  
Coronary Syndrome ◽  
Consensus Opinion

scholarly journals The Prognostic Role of Aortic Stiffness in Patients Hospitalized for an Acute Heart Failure Syndrome

2020 ◽  
Author(s):  
Sophia Giannitsi ◽  
Mara Bougiakli ◽  
Aris Bechlioulis ◽  
Anna Kotsia ◽  
Lampros Lakkas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Aortic Stiffness ◽  
Prognostic Role ◽  
Acute Heart Failure Syndrome

scholarly journals The risk of admission acute heart failure in ST-elevation myocardial infarction patients and air pollution with PM2.5

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Sinkovic ◽  
M Krasevec ◽  
D Suran ◽  
M Marinsek ◽  
A Markota
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Air Pollution ◽  
Acute Heart Failure ◽  
St Elevation Myocardial Infarction ◽  
Vascular Events ◽  
Limit Values ◽  
Predictive Role ◽  
St Elevation

Abstract Introduction Air pollution, in particular exposure to particulate matter fine particles of less than 2.5 microns in diameter (PM2.5), increases the risk of cardiovascular events. Short-term exposure (hours to few days prior) to increased PM2.5 levels even may help trigger ST-elevation myocardial infarction (STEMI) and heart failure exacerbation in susceptible individuals. The risk of vascular events is increased even in exposures below the current European air quality limit values (mean annual levels for PM2.5 less than 10μg/m3, 24-hour mean level less than 25μg/m3). Purpose To evaluate predictive role of PM2.5 levels ≥20 μg/m3 one day prior to hospital admission for the risk of admission acute heart failure (AAHF) in STEMI patients. Methods In 290 STEMI patients (100 women, 190 men, mean age 65.5±12.9 years), treated by primary percutaneous coronary intervention (PPCI) in 2018, we retrospectively registered the AAHF, defined as classes II-IV by Killip Kimbal classification. Additionally, we registered admission clinical data, potentially contributing to AAHF in STEMI patients such as gender, age ≥65 years, prior resuscitation, admission cTnI ≥5 μg/L (normal levels up to 0.045 μg/L), comorbidities, time to PPCI, and mean daily levels of PM2.5 ≥20 μg/m3 one day before admission. Mean daily, freely available, levels of PM2.5 were measured and registered by Chemical analytic laboratory of Environmental agency of Republic Slovenia. We evaluated the predictive role of admission data for admission AHF in STEMI patients. Results AAHF was observed in 34.5% of STEMI patients with the mean daily PM2.5 level 15.7±10.9 μg/m3 on the day before admission. PPCI was performed in 92.1% of all STEMI patients, in AAHF in 87.1% and in non-AAHF patients in 94.7% (p=0.037). AAHF in comparison to non-AAHF was associated significantly with female gender (50.5% vs 25.9%, p&lt;0.001), age over 65 years (71.3% vs 45%, p&lt;0.001), prior diabetes (33.7% vs 14.8%, p&lt;0.001), left bundle branch block (LBBB) (10.9% vs 0.5%, &lt;0.001), admission cTnI ≥5 μg/L (46.7% vs 25.9%, p&lt;0.001) and mean daily levels of PM2.5 ≥20 μg/m3 one day before admission (31.7% vs 19%, p=0.020), but nonsignificantly with arterial hypertension, prior myocardial infarction, anterior STEMI and time to PPCI. Logistic regression demonstrated that significant independent predictors of AAHF were age over 65 years (OR 3.349, 95% CI 1.787 to 6.277, p&lt;0.001), prior diabetes (OR 2.934, 95% CI 1.478 to 5.821, p=0.002), admission LBBB (OR 10.526, 95% CI 1.181 to 93.787, p=0.03), prior resuscitation (OR 3.221, 95% CI 1.336 to 7.761, p=0.009), admission cTnI ≥5μg/l (OR 2.984, 95% CI 1.618 to 5.502, p&lt;0.001) and mean daily levels of PM2.5 ≥20 μg/m3 (OR 2.096, 95% CI 1.045 to 4.218, p=0.038) one day before admission. Conclusion Mean daily levels of PM2.5 ≥20μg/m3 one day before admission were among significant independent predictors of AAHF in STEMI patients. FUNDunding Acknowledgement Type of funding sources: None.

Sign in / Sign up

Export Citation Format

Share Document