- Poster presentation
- Open Access
Circulating levels of tumor necrosis factor alpha, brain natriuretic peptide and cardiac Troponin I upon admission and 31-day mortality in patients with acute decompensated chronic heart failure
Critical Care volume 11, Article number: P248 (2007)
Elevated circulating levels of TNFα, brain natriuretic peptide (BNP) and cardiac Troponin I (cTnI) have been connected with adverse prognosis in patients with chronic heart failure (CHF). However, there are scant data about the predictive value of these biomarkers in combination.
A total of 577 consecutive patients (mean age: 73 ± 9 years), who were hospitalized for acute decompensation of NYHA class III/IV (65.3% of ischemic etiology) low-output (mean LVEF: 22 ± 5) CHF, were studied. Biochemical markers were measured upon admission. The incidence of 31-day death was the prespecified primary endpoint.
The incidence of the primary endpoint was 17.7%. By multivariate Cox analysis, including baseline characteristics and the study biomarkers, elevated circulating levels of TNFα (RR = 2.1; P < 0.001), BNP (RR = 3.5; P < 0.001) and cTnI (RR = 3.8; P < 0.001) were independently associated with the primary endpoint. When the patients were divided according to the number of positive biomarkers (estimated by ROC analysis) there was a significant gradual increase in the rate of the primary endpoint with increasing of the number of the positive biomarkers (4.1%, 10%, 21.5% and 53.5% 31-day mortality rate for patients with zero, one, two and three positive biomarkers, respectively; P < 0.001) (Figure 1).
The present results suggest that in patients hospitalized due to acutely decompensated severe low-output CHF, serum levels of TNFα, BNP and cTnI can be used in combination for enhanced early risk stratification.
About this article
Cite this article
Zairis, P.B., Zairis, M., Adamopoulou, E. et al. Circulating levels of tumor necrosis factor alpha, brain natriuretic peptide and cardiac Troponin I upon admission and 31-day mortality in patients with acute decompensated chronic heart failure. Crit Care 11, P248 (2007). https://0-doi-org.brum.beds.ac.uk/10.1186/cc5408
- Primary Endpoint
- Chronic Heart Failure
- Brain Natriuretic Peptide
- Cardiac Troponin
- NYHA Class