The role of plasma biomarkers in acute heart failure. Serial changes and independent prognostic value of NT-proBNP and cardiac troponin-T

Marco Metra, Savina Nodari, Giovanni Parrinello, Claudia Specchia, Loretta Brentana, Patrizia Rocca, Francesco Fracassi, Tania Bordonali, Patrizia Milani, Rossella Danesi, Giulia Verzura, Ermanna Chiari, Livio Dei Cas

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: Brain natriuretic peptide (BNP), NT-proBNP and troponins are useful for the assessment of patients with heart failure. Few data exist about their serial changes and their prognostic value in patients with acute heart failure (AHF). Methods and results: NT-proBNP and troponin-T plasma levels were measured at baseline, after 6, 12, 24, 48 h and at discharge in 116 consecutive patients with AHF and no evidence of acute coronary syndrome. NT-proBNP levels were 4421 pg/mL at baseline, declined after 24 h and reached their nadir at 48 h (2703 pg/mL). Troponin-T was detectable in 48% of patients. During a median follow-up of 184 days, 52 patients died or had a non-fatal cardiovascular hospitalisation. At a multivariable analysis including clinical and echo-Doppler variables, NT-proBNP plasma levels at discharge, detectable troponin-T plasma levels, and NYHA class at discharge were the only independent prognostic factors. Conclusion: In patients with AHF, NT-proBNP levels decline 24 h after the initiation of intravenous therapy and troponin-T is detectable in 48% of cases. NT-proBNP levels at discharge, detectable troponin-T levels, NYHA class and serum sodium have independent prognostic value.

Original languageEnglish
Pages (from-to)776-786
Number of pages11
JournalEuropean Journal of Heart Failure
Volume9
Issue number8
DOIs
Publication statusPublished - Aug 2007

Keywords

  • Acute heart failure
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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