Combination of conventional biomarkers for risk stratification in chronic heart failure.
BACKGROUND
Although there is substantial interest in the use of newer biomarkers to identify patients with chronic heart failure (CHF), recently few investigations have evaluated the incremental usefulness of multiple conventional biomarkers. Combination of several biomarkers simultaneously could enhance risk stratification in CHF.


RESULTS
We analyzed 7 biomarkers (brain natriuretic peptide, uric acid, sodium, hemoglobin, creatinine, creatinine clearance, high-sensitivity C-reactive protein), which were known as established prognostic markers for CHF, in 154 consecutive CHF patients, and patients were prospectively followed with endpoints of cardiac death or re-hospitalization. When there was an abnormal value, we scored it for one point to calculate multimarker score. Patients were categorized into 3 strata according to multimarker score. There were 83 cardiac events during the follow-up period. A Cox proportional hazard model showed that patients in the high stratum were associated with the highest risk of cardiac events among the 3 strata. Kaplan-Meier analysis revealed that patients in the high stratum had a significantly higher cardiac event rate compared with lower strata.


CONCLUSIONS
The combination of conventional biomarkers could potentially improve the risk stratification of CHF patients for the prediction of cardiac events with low cost and wide availability.
Niizeki
Takeshi
T
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan. tniizeki@nihonkai.gr.jp
Takeishi
Yasuchika
Y
Kitahara
Tatsuro
T
Suzuki
Satoshi
S
Sasaki
Toshiki
T
Ishino
Mitsunori
M
Kubota
Isao
I
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012964:Sodium / Q000097:blood; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D006454:Hemoglobins; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D002097:C-Reactive Protein; D012964:Sodium; D003404:Creatinine