Clinical benefits of natriuretic peptides and galectin-3 are maintained in old dyspnoeic patients.
BACKGROUND
Acute dyspnoea is the leading cause of unscheduled admission of elderly patients. Several biomarkers are used to diagnose acute heart failure (AHF) and assess prognosis of dyspnoeic patients, but their value in elderly patients is unclear.


OBJECTIVE
To compare diagnostic and prognostic performances of conventional and novel cardiovascular biomarkers in 2 age groups: young (<75 years old) vs. old (≥75 years old) dyspnoeic patients.


METHODS
Prospective observational registry.


METHODS
Emergency department (ED).


METHODS
Acutely dyspnoeic adult patients.


METHODS
Blood samples were collected at ED admission. The diagnostic value of 4 natriuretic peptides (BNP, proBNP, NT-proBNP, MR-proANP) for AHF was tested. We also assessed the prognostic value of same natriuretic peptides and of 3 novel cardiovascular biomarkers (galectin-3, sST2 and proenkephalin), using 1-year all-cause mortality as end-point. Diagnostic or prognostic performances are expressed as area under the receiveroperating characteristic curve (AUC) with 95% confidence interval.


RESULTS
Two hundred one acutely dyspnoeic patients were studied. AHF was the cause of dyspnoea in 57% of old and 44% of young patients, respectively. All 4 natriuretic peptides performed well in diagnosing AHF in both age groups (all AUC>0.7). BNP showed the best diagnostic performance in both old (AUC: 0.98 [0.97-1.00]) and young (AUC 0.98 [0.95-1.00]) patients. Galectin-3 showed the best prognostic performance in both old (AUC 0.74 [0.62-0.87]) and young patients (AUC 0.75 [0.56-0.94]).


CONCLUSIONS
BNP and galectin-3 show good clinical benefits in both oldand young acutely dyspnoeic patients.
Department of Geriatry, Hôpitaux Universitaires Saint Louis-Lariboisière Assistance Publique des Hôpitaux de Paris, Paris, France; University Paris Diderot, PRES Sorbonne Paris Cité, France; UMR-S 942, INSERM, Paris, France. Electronic address: antonio.teixeira@aphp.fr.
Antonio
A
Teixeira
University Paris Diderot, PRES Sorbonne Paris Cité, France; UMR-S 942, INSERM, Paris, France; Department of Anesthesiology and Critical Care Medicine, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France; Department of Cardiology, Hôpitaux Universitaires Saint Louis - Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France; Division of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
Mattia
M
Arrigo
University Paris Diderot, PRES Sorbonne Paris Cité, France; UMR-S 942, INSERM, Paris, France; Division of Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Scuola Superiore Sant'Anna, Pisa, Italy.
Giuseppe
G
Vergaro
University Paris Diderot, PRES Sorbonne Paris Cité, France; UMR-S 942, INSERM, Paris, France; Department of Cardiology, Hôpitaux Universitaires Saint Louis - Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France.
Alain
A
Cohen-Solal
University Paris Diderot, PRES Sorbonne Paris Cité, France; UMR-S 942, INSERM, Paris, France; Department of Anesthesiology and Critical Care Medicine, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France.
Alexandre
A
Mebazaa
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004417:Dyspnea / Q000209:etiology*; D004636:Emergency Service, Hospital; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D045265:Natriuretic Peptides / Q000097:blood*; D011446:Prospective Studies; D012042:Registries
D015415:Biomarkers; D037502:Galectin 3; D045265:Natriuretic Peptides
Acute heart failure; Diagnosis; Elderly; Natriuretic peptides; Prognosis