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- Title
Additive Value of Biomarkers and Echocardiography to Stratify the Risk of Death in Heart Failure Patients with Reduced Ejection Fraction.
- Authors
Falletta, Calogero; Clemenza, Francesco; Klersy, Catherine; Agnese, Valentina; Bellavia, Diego; Di Gesaro, Gabriele; Minà, Chiara; Romano, Giuseppe; Temporelli, Pier Luigi; Dini, Frank Lloyd; Rossi, Andrea; Raineri, Claudia; Turco, Annalisa; Traversi, Egidio; Ghio, Stefano
- Abstract
Background. Risk stratification is a crucial issue in heart failure. Clinicians seek useful tools to tailor therapies according to patient risk. Methods. A prospective, observational, multicenter study on stable chronic heart failure outpatients with reduced left ventricular ejection fraction (HFrEF). Baseline demographics, blood, natriuretic peptides (NPs), high-sensitivity troponin I (hsTnI), and echocardiographic data, including the ratio between tricuspid annular plane excursion and systolic pulmonary artery pressure (TAPSE/PASP), were collected. Association with death for any cause was analyzed. Results. Four hundred thirty-one (431) consecutive patients were enrolled in the study. Fifty deaths occurred over a median follow-up of 32 months. On the multivariable Cox model analysis, TAPSE/PASP ratio, number of biomarkers above the threshold values, and gender were independent predictors of death. Both the TAPSE/PASP ratio ≥0.36 and TAPSE/PASP unavailable groups had a three-fold decrease in risk of death in comparison to the TAPSE/PASP ratio <0.36 group. The risk of death increased linearly by 1.6 for each additional positive biomarker and by almost two for women compared with men. Conclusions. In a HFrEF outpatient cohort, the evaluation of plasma levels of both NPs and hsTnI can contribute significantly to identifying patients who have a worse prognosis, in addition to the echocardiographic assessment of right ventricular-arterial coupling.
- Subjects
HEART failure; MORTALITY risk factors; BIOMARKERS; COMPARATIVE studies; CAUSES of death; ECHOCARDIOGRAPHY; PSYCHOLOGY of cardiac patients; LONGITUDINAL method; MEDICAL cooperation; MULTIVARIATE analysis; SCIENTIFIC observation; RESEARCH; RISK assessment; SEX distribution; DESCRIPTIVE statistics; STROKE volume (Cardiac output); VENTRICULAR ejection fraction; PROGNOSIS
- Publication
Cardiology Research & Practice, 2019, p1
- ISSN
2090-8016
- Publication type
Article
- DOI
10.1155/2019/1824816