title: Risk stratification of chronic heart failure patients by multiple biomarkers: implications of BNP, H-FABP, and PTX3.
abstract: BACKGROUND
  B-type natriuretic peptide (BNP), heart-type fatty acid-binding protein (H-FABP), and pentraxin 3 (PTX3) each predict adverse cardiac events in chronic heart failure (CHF) patients. For prognostic evaluation from different aspects, the utility of combined measurement of the 3 biomarkers in patients with CHF was examined in the present study.
  
  
  RESULTS
  Levels of BNP (associated with left ventricular dysfunction, positive if >200 pg/ml), H-FABP (marker of myocardial damage, positive if >4.1 ng/ml), and PTX3 (marker of inflammation, positive if >4.0 ng/ml) were measured in 164 consecutive CHF patients, and patients were prospectively followed with endpoints of cardiac death or rehospitalization. When patients were categorized on the basis of the number of elevated biomarkers, patients with 1, 2, and 3 elevated biomarkers had a 5.4-fold (not significant), 11.2-old (p<0.05), and 34.6-fold increase (p<0.01), respectively, in the risk of adverse cardiac events compared with those without elevated biomarkers. Kaplan-Meier analysis revealed that patients with 3 elevated biomarkers had a significantly higher cardiac event rate than patients with a lower number of elevated biomarkers.
  
  
  CONCLUSIONS
  The combination of these 3 biomarkers could reliably risk-stratify CHF patients for prediction of cardiac events.
authors.affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ishino
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Niizeki
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Joji
authors.initials: J
authors.lastname: Nitobe
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Takehiko
authors.initials: T
authors.lastname: Miyashita
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Kitahara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Sasaki
authors.forename: Olga
authors.initials: O
authors.lastname: Bilim
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002908:Chronic Disease; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D000683:Serum Amyloid P-Component / Q000032:analysis*; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D050556:Fatty Acid-Binding Proteins; D020097:Natriuretic Peptide, Brain; D000683:Serum Amyloid P-Component; D000099153:Pentraxins