Prognostic value of DCTA scoring system in heart failure

• Published in: Herz 2021-09, Vol.46 (Suppl 2), p.243-252
• Main Authors: Zhao, Tian-Jun, Yang, Qian-Kun, Bi, Li-Dan, Li, Jie, Tan, Chun-Yu, Miao, Zhi-Lin
• Format: Article
• Language: English
• Subjects: Albumin; Biomarkers; Calcium-binding protein; Cardiology; Cholesterol; Congestive heart failure; Dimers; Edetic Acid - analogs & derivatives; Heart failure; Heart Failure - diagnosis; Humans; Internal Medicine; Medicine; Medicine & Public Health; Multivariate analysis; Original Articles; Prognosis; Rank tests; Retrospective Studies; Risk; Risk groups; Serum albumin; Statistical models; Troponin; Troponin T
• ISSN: 0340-9937; 1615-6692
• DOI: 10.1007/s00059-020-04993-1

Objective The aim of this study was to evaluate the prognostic value of a novel scoring system, based on D‑dimer, total cholesterol, high-sensitivity cardiac troponin T (hs-cTnT), and serum albumin levels, in patients with heart failure. Methods A total of 221 patients diagnosed with heart failure between May 2016 to January 2020 were enrolled in this retrospective study. The prognostic significance of the biomarkers D‑dimer, total cholesterol, hs-cTnT, and serum albumin was determined with univariate and multivariate Cox proportional hazard models. A novel prognostic score based on these predictors was established. The Kaplan–Meier method and log-rank test were used to compare the adverse outcomes of patients in different risk groups. Result Results from univariate and multivariate analyses showed that high D‑dimer, low serum albumin, high hs-cTnT, and low total cholesterol levels were independent prognostic factors for adverse outcomes (D-dimer >0.63 mg/l, HR = 1.84, 95% CI = 1.16–2.94, p  = 0.010; serum albumin >34 g/l, HR = 0.67, 95% CI = 0.45–0.99, p  = 0.046; hs-cTnT >24.06 pg/ml, HR = 1.65, 95% CI = 1.08–2.53, p  = 0.020; total cholesterol >3.68 mmol/l, HR = 0.63, 95% CI = 0.43–0.92, p  = 0.017). Moreover, all the patients were stratified into low-risk or high-risk group according to a scoring system based on these four markers. Kaplan–Meier analyses demonstrated that patients in the high-risk group were more prone to having adverse outcomes compared with patients in the low-risk group. Conclusion D‑dimer, total cholesterol, hs-cTnT, and serum albumin levels were independent prognostic factors in the setting of heart failure. A novel and comprehensive scoring system based on these biomarkers is an easily available and effective tool for predicting the adverse outcomes of patients with heart failure.