Risk Stratification of Chronic Heart Failure Patients by Multiple Biomarkers-Implications of BNP, H-FABP, and PTX3-
Risk Stratification of Chronic Heart Failure Patients by Multiple Biomarkers-Implications of BNP, H-FABP, and PTX3-
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DOI：
10.1253/circj.cj-08-0157
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发表时间：
2008-11-01
影响因子：
3.3
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Ishino, Mitsunori;Takeishi, Yasuchika;Kubota, Isao
背景：B型利钠肽（BNP）、心脏型脂肪酸结合蛋白（H-FABP）和正五聚蛋白3（PTX 3）均能预测慢性心力衰竭（CHF）患者的不良心脏事件。为了从不同方面进行预后评估，本研究检查了3种生物标志物在CHF患者中的联合测量的效用。（与左心室功能障碍相关，如果> 200 pg/ml，则为阳性），H-FABP（心肌损伤的标志物，如果> 4.1 ng/ml，则为阳性）和PTX 3（炎症标志物，如果> 4.0 ng/ml则为阳性），并以心源性死亡或再住院为终点对患者进行前瞻性随访。当根据生物标志物升高的数量对患者进行分类时，与生物标志物未升高的患者相比，具有1、2和3个生物标志物升高的患者的不良心脏事件风险分别增加5.4倍（不显著）、11.2倍（p < 0.05）和34.6倍（p < 0.01）。Kaplan-Meier分析显示3种生物标志物升高的CHF患者心脏事件发生率显著高于3种生物标志物升高的CHF患者。结论3种生物标志物的联合应用可对CHF患者进行危险分层，从而预测CHF患者的心脏事件。(Circ J 2008; 72：1800-1805）
Background B-type natriuretic peptide (BNP), heart-type fatty acid-binding protein (H-FABP), and pentraxin 3 (PTX3) each predict adverse cardiac events in chronic heart failure (CHF) patients. For prognostic evaluation from different aspects, the utility of combined measurement of the 3 biomarkers in patients with CHF was examined in the present study.Methods and Results Levels of BNP (associated with left ventricular dysfunction, positive if > 200 pg/ml), H-FABP (marker of myocardial damage, positive if > 4.1 ng/ml), and PTX3 (marker of inflammation, positive if > 4.0 ng/ml) were measured in 164 consecutive CHF patients, and patients were prospectively followed with endpoints of cardiac death or rehospitalization. When patients were categorized on the basis of the number of elevated biomarkers, patients with 1, 2, and 3 elevated biomarkers had a 5.4-fold (not significant), 11.2-old (p < 0.05), and 34.6-fold increase (p < 0.01), respectively, in the risk of adverse cardiac events compared with those without elevated biomarkers. Kaplan-Meier analysis revealed that patients with 3 elevated biomarkers had a significantly higher cardiac event rate than patients with a lower number of elevated biomarkers.Conclusion The combination of these 3 biomarkers could reliably risk-stratify CHF patients for prediction of cardiac events. (Circ J 2008; 72: 1800-1805)