Background: The Biomarkers in Acute Heart Failure (BACH) study examined the utility of a panel of novel prohormone cardiovascular biomarkers in diagnosing heart failure (HF), but little is known about how levels of these markers vary between racial groups. Methods: 1641 patients presenting to the ED with acute dyspnea were enrolled in the prospective, multinational, 15-center BACH trial, and plasma levels of several prohormone biomarker fragments were measured. The diagnosis of HF was determined by 2 independent cardiologists, blinded to the ED physicians’ diagnoses and to the biomarker levels being examined in the trial. Race was determined by self-report. Results: Of the 1626 patients of known race, 67% were white and 29% were black. White patients were more likely to have a final diagnosis of HF than black patients (40% vs. 25%, p <0.001). Median levels of all BACH markers except CT-proAVP were lower in blacks than in whites among patients with a final diagnosis other than acute HF; in those with acute HF, levels differed by race only for MR-proANP, which was higher in blacks (519 pmol/L vs. 395 pmol/L, p=0.002). All BACH markers were stronger predictors of HF in blacks than in whites, with MR-proANP emerging as an especially powerful predictor in blacks (AUC=0.946, Figure). Adjusting for age did not materially alter the results. Conclusions: Novel prohormone biomarkers performed better in blacks than in whites for diagnosing acute HF. MR-proANP proved an especially accurate predictor in black patients
Effect of race on the diagnostic performance of novel cardiovascular biomarkers in patients with dyspnea: results from the BACH multinational study / Lori B., D., Sonal, S., Paul, C., Stefan D., A., Inder, A., Robert, C., DI SOMMA, S., Gerasimos, F., Christopher, H., Michael, H., James, M., Martin, M., Christian, M., Sean Xavier, N., Leong, N.g., Richard, N., W., F.P., Piotr, P., Mihael, P., A., M.R., et al.. - In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. - ISSN 0735-1097. - STAMPA. - 53:(2009), pp. A185-A185.
Effect of race on the diagnostic performance of novel cardiovascular biomarkers in patients with dyspnea: results from the BACH multinational study
DI SOMMA, Salvatore;
2009
Abstract
Background: The Biomarkers in Acute Heart Failure (BACH) study examined the utility of a panel of novel prohormone cardiovascular biomarkers in diagnosing heart failure (HF), but little is known about how levels of these markers vary between racial groups. Methods: 1641 patients presenting to the ED with acute dyspnea were enrolled in the prospective, multinational, 15-center BACH trial, and plasma levels of several prohormone biomarker fragments were measured. The diagnosis of HF was determined by 2 independent cardiologists, blinded to the ED physicians’ diagnoses and to the biomarker levels being examined in the trial. Race was determined by self-report. Results: Of the 1626 patients of known race, 67% were white and 29% were black. White patients were more likely to have a final diagnosis of HF than black patients (40% vs. 25%, p <0.001). Median levels of all BACH markers except CT-proAVP were lower in blacks than in whites among patients with a final diagnosis other than acute HF; in those with acute HF, levels differed by race only for MR-proANP, which was higher in blacks (519 pmol/L vs. 395 pmol/L, p=0.002). All BACH markers were stronger predictors of HF in blacks than in whites, with MR-proANP emerging as an especially powerful predictor in blacks (AUC=0.946, Figure). Adjusting for age did not materially alter the results. Conclusions: Novel prohormone biomarkers performed better in blacks than in whites for diagnosing acute HF. MR-proANP proved an especially accurate predictor in black patientsI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
