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Research Article Open access CC BY 3.0

Steady-State Levels of Troponin and Brain Natriuretic Peptide for Prediction of Long-Term Outcome after Acute Heart Failure with or without Stage 3 to 4 Chronic Kidney Disease

Yutaka Endo, Shun Kohsaka, Toshiyuki Nagai, Kimi Koide, Masashi Takahashi, Yuji Nagatomo, Kazuki Oshima, Hiroaki Miyata, Keiichi Fukuda, Tsutomu Yoshikawa

Journal of Advances in Medicine and Medical Research · pp. 490–500 · Published 23 Aug 2012

10.9734/BJMMR/2012/1384

Abstract

Aim: To determine whether assessment of a combination of steady-state discharge levels of biomarkers improves risk stratification after acute decompensate HF. Study Design: Retrospective cohort study. Place and Duration of Study: Keio University Hospital, between January 2006 and September 2011. We analyzed 244 patients with acute HF due to ischemic or dilated cardiomyopathy who were enrolled in a prospective, single institution-based registry between January 2006 and September 2011. Patients were stratified by discharge values of BNP and/or TnT. The primary endpoint was a composite of HF readmission or death during the 2-year period after discharge. Results: The population was predominantly male (69.3%), and the mean age was 66.6±15.3 years. Patients with higher BNP levels or detectable TnT had a worse prognosis (BNP45.0% vs. 18.8%, p<0.001; TnT 43.8% vs. 25.1%, p=0.002, respectively). The primary event rate was additively worse among patients with both increased BNP levels and detectable TnT compared to those with increased levels of BNP or detectable TnT alone (log-rank p<0.001). A similar trend was observed in the subgroup of patients with CKD stage III–V (n=172). Conclusion: Assessment of both BNP and TnT values may have a significant predictive value for HF prognosis, even among patients with CKD, a condition affecting biomarker levels.

Biomarkers heart failure chronic kidney disease.

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