The role of plasma biomarkers in acute heart failure. Serial changes and independent prognostic value of NT-proBNP and cardiac troponin-T

Aims Brain natriuretic peptide (BNP), NT-proBNP and troponins are useful for the assessment of patients with heart failure. Few data exist about their serial changes and their prognostic value in patients with acute heart failure (AHF). Methods and results NT-proBNP and troponin-T plasma levels were...

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Published in:European journal of heart failure 2007-08, Vol.9 (8), p.776-786
Main Authors: Metra, Marco, Nodari, Savina, Parrinello, Giovanni, Specchia, Claudia, Brentana, Loretta, Rocca, Patrizia, Fracassi, Francesco, Bordonali, Tania, Milani, Patrizia, Danesi, Rossella, Verzura, Giulia, Chiari, Ermanna, Cas, Livio Dei
Format: Article
Language:English
Subjects:
Acute Disease
acute heart failure
Aged
Biomarkers - blood
Echocardiography, Doppler
Female
Heart Failure - blood
Heart Failure - diagnostic imaging
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Prognosis
Risk Assessment
Troponin T - blood
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Summary:Aims Brain natriuretic peptide (BNP), NT-proBNP and troponins are useful for the assessment of patients with heart failure. Few data exist about their serial changes and their prognostic value in patients with acute heart failure (AHF). Methods and results NT-proBNP and troponin-T plasma levels were measured at baseline, after 6, 12, 24, 48 h and at discharge in 116 consecutive patients with AHF and no evidence of acute coronary syndrome. NT-proBNP levels were 4421 pg/mL at baseline, declined after 24 h and reached their nadir at 48 h (2703 pg/mL). Troponin-T was detectable in 48% of patients. During a median follow-up of 184 days, 52 patients died or had a non-fatal cardiovascular hospitalisation. At a multivariable analysis including clinical and echo-Doppler variables, NT-proBNP plasma levels at discharge, detectable troponin-T plasma levels, and NYHA class at discharge were the only independent prognostic factors. Conclusion In patients with AHF, NT-proBNP levels decline 24 h after the initiation of intravenous therapy and troponin-T is detectable in 48% of cases. NT-proBNP levels at discharge, detectable troponin-T levels, NYHA class and serum sodium have independent prognostic value.
ISSN:1388-9842
1879-0844
DOI:10.1016/j.ejheart.2007.05.007