Diagnostic and prognostic value of osteopontin in patients with acute congestive heart failure
Diagnostic and prognostic value of osteopontin in patients with acute congestive heart failure
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DOI：
10.1093/eurjhf/hft112
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发表时间：
2013-12-01
影响因子：
18.2
通讯作者：
Hoffmann, Ursula
中科院分区：
文献类型：
--
作者：
Behnes, Michael;Brueckmann, Martina;Hoffmann, Ursula
旨在评估骨桥蛋白对疑似急性充血性心力衰竭 (aCHF) 的急性呼吸困难和/或外周水肿患者的诊断和预后价值。前瞻性入组了 401 名因急性呼吸困难和/或外周水肿到急诊科就诊的患者，并随访长达 5 年。在进入急诊室时收集了用于生物标志物测量的血样。测试了骨桥蛋白联合 NT-proBNP 与单独 NT-proBNP 诊断 aCHF 的效果。此外，还测试了骨桥蛋白与 NT-proBNP 的预后结果（即全因死亡率、aCHF 相关再住院以及两者的组合）。通过 C 统计、重分类指数和多变量 Cox 预测模型测试骨桥蛋白的诊断和预后能力。骨桥蛋白联合 NT-proBNP 提高了 aCHF 诊断的能力 [准确度 76, 95 置信区间 (CI) 7280；特异性 74, 95 CI 6979，净重分类改善 (NRI) 0.10] 与急诊科单独使用 NT-proBNP 相比 (P < 0.0001)。骨桥蛋白独立预测 1 年后和 5 年后的全因死亡率和 aCHF 相关的再住院率。与 NT-proBNP 相比，骨桥蛋白具有优越的预后价值，特别是对于 aCHF 患者以及 aCHF 相关再住院的预后结果。骨桥蛋白与 NT-proBNP 联合使用可改善 aCHF 诊断。骨桥蛋白可识别 1 年和 5 年死亡率和再住院风险较高的 aCHF 患者，并为 NT-proBNP.NCT00143793 添加预后价值。
To evaluate the diagnostic and prognostic value of osteopontin in patients with acute dyspnoea and/or peripheral oedema suspected of having acute congestive heart failure (aCHF).A total of 401 patients presenting with acute dyspnoea and/or peripheral oedema to the emergency department were prospectively enrolled and followed up for up to 5 years. Blood samples for biomarker measurements were collected on admission to the emergency department. Osteopontin combined with NT-proBNP vs. NT-proBNP alone for diagnosis of aCHF was tested. Additionally, osteopontin vs. NT-proBNP for prognostic outcomes (i.e. all-cause mortality, aCHF-related rehospitalization, and both in combination) was tested. The diagnostic and prognostic capacity of osteopontin was tested by C-statistics, reclassification indices, and multivariable Cox prediction models. Osteopontin plus NT-proBNP improved the diagnostic capacity for aCHF diagnosis [accuracy 76, 95 confidence interval (CI) 7280; specificity 74, 95 CI 6979, net reclassification improvement (NRI) 0.10] compared with NT-proBNP alone in the emergency department (P 0.0001). Osteopontin independently predicted all-cause mortality and aCHF-related rehospitalization after 1 and 5 years. Compared with NT-proBNP, osteopontin was of superior prognostic value, specifically in aCHF patients and for the prognostic outcome of aCHF-related rehospitalization.Osteopontin improves aCHF diagnosis when combined with NT-proBNP. Osteopontin identifies aCHF patients with high 1- and 5-year mortality and rehospitalization risk, and adds prognostic value to NT-proBNP.NCT00143793.