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  • 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

  • 1,
  • 2,
  • 2,
  • 1 and
  • 2
Critical Care200711 (Suppl 2) :P248

https://doi.org/10.1186/cc5408

  • Published:

Keywords

  • Primary Endpoint
  • Chronic Heart Failure
  • Brain Natriuretic Peptide
  • Cardiac Troponin
  • NYHA Class

Background

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.

Methods

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.

Results

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).
Figure 1
Figure 1

abstract

Conclusion

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.

Authors’ Affiliations

(1)
Metaxa Hospital, Piraeus, Greece
(2)
Tzanio Hospital, Piraeus, Greece

Copyright

© BioMed Central Ltd. 2007

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