Evaluation of novel biomarkers for the diagnosis of acute destabilised heart failure in patients with shortness of breath.
OBJECTIVE
The evaluation of novel biomarkers for the diagnosis of acute destabilised heart failure (HF).


METHODS
Prospectively conducted study on diagnostic accuracy.


METHODS
Emergency department of a tertiary care hospital.


METHODS
251 consecutive patients presenting to the emergency department with dyspnoea as the chief complaint.


METHODS
Index tests were plasma concentrations of 10 biomarkers (BNP, MR-proANP, MR-proADM, copeptin, CT-proET-1, ST2, adiponectin, chromogranin A, proguanylin and prouroguanylin). The reference standard was the diagnosis of acute destabilised HF, which was based on the Framingham score for HF plus echocardiographic evidence of systolic or diastolic dysfunction.


RESULTS
Median plasma concentrations of all 10 biomarkers were higher in patients with dyspnoea attributable to acute destabilised HF (n = 137) than in patients with dyspnoea attributable to other reasons (n = 114). Applying receiver operating characteristic curve (ROC) analyses, areas under the curve (AUCs) for BNP (0.92) and MR-proANP (0.88) were significantly higher than the AUCs of the other eight biomarkers (MR-proADM, 0.75; adiponectin, 0.73; CT-proET-1, 0.72; proguanylin, 0.68; ST2, 0.67; prouroguanylin, 0.62; copeptin, 0.62; and chromogranin A, 0.56). In multivariate logistic regression analysis only increased BNP and MR-proANP concentrations remained independent markers for the diagnosis of HF. Both markers alone or in combination added similar diagnostic information besides all clinical information available in the emergency department.


CONCLUSIONS
The data showed that BNP and MR-proANP were the only independent diagnostic markers of HF. Both markers provided similar diagnostic information and were clinically useful as an aid in the diagnosis of acute destabilised HF in an emergency setting.
Dieplinger
B
B
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria.
Gegenhuber
A
A
Haltmayer
M
M
Mueller
T
T
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D015415:Biomarkers