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Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment?
AIMS: Heart failure (HF) management is complicated by difficulties in clinical assessment. Biomarkers may help guide HF management, but the correspondence between clinical evaluation and biomarker serum levels has hardly been studied. We investigated the correlation between biomarkers and clinical s...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bohn Stafleu van Loghum
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931853/ https://www.ncbi.nlm.nih.gov/pubmed/24338787 http://dx.doi.org/10.1007/s12471-013-0503-y |
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author | Peeters, J. M. P. W. U. Sanders-van Wijk, S. Bektas, S. Knackstedt, C. Rickenbacher, P. Nietlispach, F. Handschin, R. Maeder, M. T. Muzzarelli, S. F. Pfisterer, M. E. Brunner-La Rocca, H. P. |
author_facet | Peeters, J. M. P. W. U. Sanders-van Wijk, S. Bektas, S. Knackstedt, C. Rickenbacher, P. Nietlispach, F. Handschin, R. Maeder, M. T. Muzzarelli, S. F. Pfisterer, M. E. Brunner-La Rocca, H. P. |
author_sort | Peeters, J. M. P. W. U. |
collection | PubMed |
description | AIMS: Heart failure (HF) management is complicated by difficulties in clinical assessment. Biomarkers may help guide HF management, but the correspondence between clinical evaluation and biomarker serum levels has hardly been studied. We investigated the correlation between biomarkers and clinical signs and symptoms, the influence of patient characteristics and comorbidities on New York Heart Association (NYHA) classification and the effect of using biomarkers on clinical evaluation. METHODS AND RESULTS: This post-hoc analysis comprised 622 patients (77 ± 8 years, 76 % NYHA class ≥3, 80 % LVEF ≤45 %) participating in TIME-CHF, randomising patients to either NT-proBNP-guided or symptom-guided therapy. Biomarker measurements and clinical evaluation were performed at baseline and after 1, 3, 6, 12 and 18 months. NT-proBNP, GDF-15, hs-TnT and to a lesser extent hs-CRP and cystatin-C were weakly correlated to NYHA, oedema, jugular vein distension and orthopnoea (ρ-range: 0.12–0.33; p < 0.01). NT-proBNP correlated more strongly to NYHA class in the NT-proBNP-guided group compared with the symptom-guided group. NYHA class was significantly influenced by age, body mass index, anaemia, and the presence of two or more comorbidities. CONCLUSION: In HF, biomarkers correlate only weakly with clinical signs and symptoms. NYHA classification is influenced by several comorbidities and patient characteristics. Clinical judgement seems to be influenced by a clinician’s awareness of NT-proBNP concentrations. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12471-013-0503-y) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-3931853 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-39318532014-02-28 Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment? Peeters, J. M. P. W. U. Sanders-van Wijk, S. Bektas, S. Knackstedt, C. Rickenbacher, P. Nietlispach, F. Handschin, R. Maeder, M. T. Muzzarelli, S. F. Pfisterer, M. E. Brunner-La Rocca, H. P. Neth Heart J Original Article AIMS: Heart failure (HF) management is complicated by difficulties in clinical assessment. Biomarkers may help guide HF management, but the correspondence between clinical evaluation and biomarker serum levels has hardly been studied. We investigated the correlation between biomarkers and clinical signs and symptoms, the influence of patient characteristics and comorbidities on New York Heart Association (NYHA) classification and the effect of using biomarkers on clinical evaluation. METHODS AND RESULTS: This post-hoc analysis comprised 622 patients (77 ± 8 years, 76 % NYHA class ≥3, 80 % LVEF ≤45 %) participating in TIME-CHF, randomising patients to either NT-proBNP-guided or symptom-guided therapy. Biomarker measurements and clinical evaluation were performed at baseline and after 1, 3, 6, 12 and 18 months. NT-proBNP, GDF-15, hs-TnT and to a lesser extent hs-CRP and cystatin-C were weakly correlated to NYHA, oedema, jugular vein distension and orthopnoea (ρ-range: 0.12–0.33; p < 0.01). NT-proBNP correlated more strongly to NYHA class in the NT-proBNP-guided group compared with the symptom-guided group. NYHA class was significantly influenced by age, body mass index, anaemia, and the presence of two or more comorbidities. CONCLUSION: In HF, biomarkers correlate only weakly with clinical signs and symptoms. NYHA classification is influenced by several comorbidities and patient characteristics. Clinical judgement seems to be influenced by a clinician’s awareness of NT-proBNP concentrations. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12471-013-0503-y) contains supplementary material, which is available to authorized users. Bohn Stafleu van Loghum 2013-12-14 2014-03 /pmc/articles/PMC3931853/ /pubmed/24338787 http://dx.doi.org/10.1007/s12471-013-0503-y Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Article Peeters, J. M. P. W. U. Sanders-van Wijk, S. Bektas, S. Knackstedt, C. Rickenbacher, P. Nietlispach, F. Handschin, R. Maeder, M. T. Muzzarelli, S. F. Pfisterer, M. E. Brunner-La Rocca, H. P. Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment? |
title | Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment? |
title_full | Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment? |
title_fullStr | Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment? |
title_full_unstemmed | Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment? |
title_short | Biomarkers in outpatient heart failure management; Are they correlated to and do they influence clinical judgment? |
title_sort | biomarkers in outpatient heart failure management; are they correlated to and do they influence clinical judgment? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931853/ https://www.ncbi.nlm.nih.gov/pubmed/24338787 http://dx.doi.org/10.1007/s12471-013-0503-y |
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