Portal de investigación
Prognostic value of NT-proBNP and CA125 across glomerular filtration rate categories in acute heart failure.
Fecha de publicación:
Fecha Ahead of Print:
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Bayes-Genis, Antoni
- Llacer, Pau
Grupos y Plataformas de I+D+i
Abstract
BACKGROUND: This study aimed to evaluate whether glomerular filtration rate (eGFR) during admission modifies the predictive value of plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP) and carbohydrate antigen 125 (CA125) in patients hospitalized for acute heart failure (AHF). METHODS: We retrospectively evaluated 4595 patients consecutively discharged after admission for AHF at three tertiary-care hospitals from January 2008 through October 2019. To investigate the effect of kidney function on the association of NT-proBNP and CA125 with 1-year mortality (all-cause and cardiovascular mortality), we stratified patients according to four eGFR categories: <30 mL•min(-1)•1.73 m(-2), 30-44 mL•min(-1)•1.73 m(-2), 44-59 mL•min(-1)•1.73 m(-2), and =60 mL•min(-1)•1.73 m(-2). Biomarkers were assessed within the first 24 hours following admission. RESULTS: At 1-year follow-up, 748 of 4595 (16.3%) patients died after discharge (of all deaths, 575 [12.5%] were cardiovascular). After multivariate adjustment, both NT-proBNP and CA125 remained independently associated with a higher risk of death when modeled as main effects (P<0.001). However, we found a differential prognostic effect of NT-proBNP across eGFR categories for both endpoints (all-cause mortality, P-value for interaction=0.002; CV mortality, P-value for interaction=0.001). Whereas NT-proBNP was positively and linearly associated with mortality in the subset of patients with normal or mildly reduced eGFR, its predictive ability progressively decreased at the lower extreme of eGFR (<45 mL•min(-1)•1.73 m(-2)). In contrast, the association between CA125 and survival remained consistent across all eGFR categories (all-cause mortality, P-value for interaction=0.559; CV mortality, P-value for interaction=0.855). CONCLUSIONS: In patients with AHF and severely reduced eGFR, CA125 outperforms NT-proBNP in predicting 1-year mortality.
Copyright © 2021. Published by Elsevier B.V.
Datos de la publicación
- ISSN/ISSNe:
- 0953-6205, 1879-0828
- Tipo:
- Article
- Páginas:
- 67-73
- PubMed:
- 34507853
European Journal of Internal Medicine ELSEVIER SCIENCE BV
Citas Recibidas en Web of Science: 19
Documentos
Filiaciones
Keywords
- Acute heart failure; CA125; Cardiorenal syndrome; NT-proBNP
Financiación
Proyectos y Estudios Clínicos
INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER
Investigador Principal: JUAN SANCHIS FORES
CB16/11/00420 . INSTITUTO SALUD CARLOS III
Cita
de la Espriella R,Bayes A,Llacer P,Palau P,Minana G,Santas E,Pellicer M,Gonzalez M,Gorriz JL,Bodi V,Sanchis J,Nunez J. Prognostic value of NT-proBNP and CA125 across glomerular filtration rate categories in acute heart failure. Eur. J. Intern. Med. 2022. 95. p. 67-73. IF:8,000. (1).
Prognostic value of NT-proBNP and CA125 across glomerular filtration rate categories in acute heart failure. de la Espriella R, Bayes A, Llacer P, Palau P, Minana G, Santas E, Pellicer M et al. European Journal of Internal Medicine. 2022 enero 01. 9567-73. DOI:10.1016/j.ejim.2021.08.024. PMID:34507853.
