© 2007 European Society of Cardiology
The role of plasma biomarkers in acute heart failure. Serial changes and independent prognostic value of NT-proBNP and cardiac troponin-T
a Section on Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Brescia Italy
b Section of Medical Statistics, Department of Medical Sciences and Biotechnology, University of Brescia Italy
* Corresponding author. Cattedra di Cardiologia, c/o Spedali Civili, Piazza Spedali Civili, 25100 Brescia, Italy. Tel.: +39 030 3995573; fax: +39 030 3700359. E-mail address: metramarco{at}libero.it
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Abstract |
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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.
Key Words: Acute heart failure • Prognosis
Received May 5, 2006; Revised March 22, 2007; Accepted May 8, 2007
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