title: The role of plasma biomarkers in acute heart failure. Serial changes and independent prognostic value of NT-proBNP and cardiac troponin-T.
abstract: OBJECTIVE
  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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Section on Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Brescia, Italy. metramarco@libero.it
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
authors.forename: Savina
authors.initials: S
authors.lastname: Nodari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Parrinello
authors.forename: Claudia
authors.initials: C
authors.lastname: Specchia
authors.forename: Loretta
authors.initials: L
authors.lastname: Brentana
authors.forename: Patrizia
authors.initials: P
authors.lastname: Rocca
authors.forename: Francesco
authors.initials: F
authors.lastname: Fracassi
authors.forename: Tania
authors.initials: T
authors.lastname: Bordonali
authors.forename: Patrizia
authors.initials: P
authors.lastname: Milani
authors.forename: Rossella
authors.initials: R
authors.lastname: Danesi
authors.forename: Giulia
authors.initials: G
authors.lastname: Verzura
authors.forename: Ermanna
authors.initials: E
authors.lastname: Chiari
authors.forename: Livio
authors.initials: L
authors.lastname: Dei Cas
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D018570:Risk Assessment; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain