RT Journal Article
SR Electronic
T1 Novel biomarkers for risk stratification in pulmonary arterial hypertension
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00008-2015
DO 10.1183/23120541.00008-2015
VO 1
IS 2
A1 Zelniker, Thomas
A1 Uhlmann, Lorenz
A1 Spaich, Sebastian
A1 Friedrich, Jörg
A1 Preusch, Michael R.
A1 Meyer, Franz J.
A1 Katus, Hugo A.
A1 Giannitsis, Evangelos
YR 2015
UL http://openres.ersjournals.com/content/1/2/00008-2015.abstract
AB Risk stratification in pulmonary arterial hypertension (PAH) is paramount to identifying individuals at highest risk of death. So far, there are only limited parameters for prognostication in patients with PAH.95 patients with confirmed PAH were included in the present analysis and followed for a total of 4 years. Blood samples were analysed for serum levels of N-terminal pro-brain natriuretic peptide, high-sensitivity troponin T (hsTnT), pro-atrial natriuretic peptide (proANP), growth differentiation factor 15, soluble fms-like tyrosine kinase 1 and placental growth factor.27 (28.4%) patients died during a follow-up of 4 years. Levels of all tested biomarkers, except for placental growth factor, were significantly elevated in nonsurvivors compared with survivors. Receiver operating characteristic analyses demonstrated that cardiac biomarkers had the highest power in predicting mortality. In particular, proANP exhibited the highest area under the curve, followed by N-terminal pro-brain natriuretic peptide and hsTnT. Furthermore, proANP and hsTnT added significant additive prognostic value to the established markers in categorical and continuous net reclassification index. Moreover, after Cox regression, proANP (hazard ratio (HR) 1.91), hsTnT (HR 1.41), echocardiographic right ventricular impairment (HR 1.30) and 6-min walk test (HR 0.97 per 10 m) remained the only significant parameters in prognostication of mortality.Our data suggest benefits of the implementation of proANP and hsTnT as additive biomarkers for risk stratification in patients with PAH.The cardiac biomarkers proANP and hsTnT may be of use in the assessment of risk stratification in PAH patients http://ow.ly/RJFtn