Risk stratification of chronic heart failure patients by multiple biomarkers: implications of BNP, H-FABP, and PTX3.
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.
Ishino
Mitsunori
M
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Takeishi
Yasuchika
Y
Niizeki
Takeshi
T
Watanabe
Tetsu
T
Nitobe
Joji
J
Miyamoto
Takuya
T
Miyashita
Takehiko
T
Kitahara
Tatsuro
T
Suzuki
Satoshi
S
Sasaki
Toshiki
T
Bilim
Olga
O
Kubota
Isao
I
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
D015415:Biomarkers; D002097:C-Reactive Protein; D050556:Fatty Acid-Binding Proteins; D020097:Natriuretic Peptide, Brain; D000683:Serum Amyloid P-Component; D000099153:Pentraxins