Combination of Uric Acid and NT-ProBNP: A More Useful Prognostic Marker for Short-Term Clinical Outcomes in Patients with Acute Heart Failure.
10.3904/kjim.2010.25.3.253
- Author:
Hyoung Seob PARK
1
;
Hyungseop KIM
;
Ji Hyun SOHN
;
Hong Won SHIN
;
Yun Kyeong CHO
;
Hyuck Jun YOON
;
Chang Wook NAM
;
Seung Ho HUR
;
Yoon Nyun KIM
;
Kwon Bae KIM
;
Hee Joon PARK
Author Information
1. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. khyungseop@dsmc.or.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Uric acid;
Natriuretic peptides;
Heart failure
- MeSH:
Aged;
Aged, 80 and over;
Biological Markers/blood;
Female;
Heart Failure/*blood/therapy;
Humans;
Kaplan-Meiers Estimate;
Male;
Middle Aged;
Natriuretic Peptide, Brain/*blood;
Peptide Fragments/*blood;
Prognosis;
Treatment Outcome;
Uric Acid/*blood
- From:The Korean Journal of Internal Medicine
2010;25(3):253-259
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: In patients with heart failure (HF), N-terminal prohormone brain natriuretic peptide (NT-ProBNP) is a standard prognostic indicator. In addition, uric acid (UA) was recently established as a prognostic marker for poor outcome in chronic HF. The aim of this study was to determine the combined role of UA and NT-ProBNP as prognostic markers for short-term outcomes of acute heart failure (AHF). METHODS: The levels of UA and NT-ProBNP were determined in 193 patients (age, 69 +/- 13 years; 76 males) admitted with AHF. Patients were followed for 3 months and evaluated for cardiovascular events, defined as cardiac death and/or readmission for HF. RESULTS: Of the 193 patients, 23 (11.9%) died and 20 (10.4%) were readmitted for HF during the 3-month follow-up period. Based on univariate analysis, possible predictors of short-term cardiovascular events were high levels of UA and NT-ProBNP, low creatinine clearance, no angiotensin converting enzyme inhibitors or angiotensin receptor blockers, and old age. Multivariate Cox hazard analysis showed that UA levels were independently associated with increased incidence of cardiovascular events (hazard ratio, 1.115; 95% confidence interval, 1.006 to 1.235; p = 0.037). Kaplan-Meier survival analysis revealed that patients with UA levels > 8.0 mg/dL and NT-ProBNP levels > 4,210 pg/mL were at highest risk for cardiac events (p = 0.01). CONCLUSIONS: The combination of UA and NT-ProBNP levels appears to be more useful than either marker alone as an independent predictor for short-term outcomes in patients with AHF.
