Background: B-type natriuretic peptide (BNP) levels are useful in the diagnosis of heart failure (HF) in patients with acute dyspnea, but their diagnostic value is confounded by age. We examined the impact of age on the levels and utility of novel cardiac biomarkers in a secondary analysis of the Biomarkers in ACute Heart Failure (BACH) study. Methods: The BACH study was a multinational 15-center prospective study of the use of novel cardiovascular prohormone fragments in diagnosing HF among dyspneic patients presenting to the ED. HF diagnosis was determined by 2 independent cardiologists who were blinded to the ED physicians’ diagnoses and to the biomarker levels being examined in this study. Results: The mean age of the 1641 subjects was 64±17 years; the 568 (35%) patients with a final diagnosis of HF were older than those with alternate diagnoses (71 vs. 60 years, p <0.001). In patients without acute HF, median levels of all BACH markers (CTproET, MR-proADM, MR-proANP, CT-proAVP) increased significantly with increasing age group (p <0.001), as did levels of MR-proADM (p=0.001) and MR-proANP (p=0.025) in subjects with HF. The area under the ROC curve was largest in the youngest age group and decreased with age, suggesting that the BACH markers were stronger predictors in younger patients Conclusions: The utility of the studied prohormone biomarkers for diagnosing acute HF varies by age. The BACH biomarkers proved to be a powerful adjunct to the diagnosis of HF, especially in younger patients
Impact of age on the levels and utility of novel cardiac biomarkers in diagnosing acute heart failure: results from the BACH Multinational Study / Lori B., Daniels; Kimberly, Tran; Paul, Clopton; Stefan D., Anker; Inder, Anand; Robert, Christenson; DI SOMMA, Salvatore; Gerasimos, Filippatos; Christopher, Hogan; Michael, Hudson; James, Mccord; Martin, Möckel; Christian, Müller; Sean Xavier, Neath; Leong, Ng; Richard, Nowak; W., Franklin Peacock; Piotr, Ponikowski; Mihael, Potocki; A., Mark Richards; Alan, Wu; Alan S., Maisel; University of, California; San, Diego; San, Diego; Ca, ; Veterans Affairs San Diego Healthcare, System; La, Jolla; Ca,. - In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. - ISSN 0735-1097. - STAMPA. - 53:(2009), pp. A156-A157.
Impact of age on the levels and utility of novel cardiac biomarkers in diagnosing acute heart failure: results from the BACH Multinational Study
DI SOMMA, Salvatore;
2009
Abstract
Background: B-type natriuretic peptide (BNP) levels are useful in the diagnosis of heart failure (HF) in patients with acute dyspnea, but their diagnostic value is confounded by age. We examined the impact of age on the levels and utility of novel cardiac biomarkers in a secondary analysis of the Biomarkers in ACute Heart Failure (BACH) study. Methods: The BACH study was a multinational 15-center prospective study of the use of novel cardiovascular prohormone fragments in diagnosing HF among dyspneic patients presenting to the ED. HF diagnosis was determined by 2 independent cardiologists who were blinded to the ED physicians’ diagnoses and to the biomarker levels being examined in this study. Results: The mean age of the 1641 subjects was 64±17 years; the 568 (35%) patients with a final diagnosis of HF were older than those with alternate diagnoses (71 vs. 60 years, p <0.001). In patients without acute HF, median levels of all BACH markers (CTproET, MR-proADM, MR-proANP, CT-proAVP) increased significantly with increasing age group (p <0.001), as did levels of MR-proADM (p=0.001) and MR-proANP (p=0.025) in subjects with HF. The area under the ROC curve was largest in the youngest age group and decreased with age, suggesting that the BACH markers were stronger predictors in younger patients Conclusions: The utility of the studied prohormone biomarkers for diagnosing acute HF varies by age. The BACH biomarkers proved to be a powerful adjunct to the diagnosis of HF, especially in younger patientsI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
