Different biochemical profile of stable and decompensated systolic heart failure patients due to ischemic or dilated cardiomyopathy hospitalized in the tertiary cardiology center (RCD code: III-1)
Aim: This study aims to compare the extended biochemical profile of unselected and consecutive systolic heart failure (SHF) patients admitted electively and urgently to the tertiary cardiology center. Methods: This study is a retrospective analysis of the 310 consecutive SHF patients who were hospitalized between January 2011 till December 2013. Data about health status of the patients, medications, as well as laboratory data, including indicators of myocardial damage, such as high–sensitivity troponins (hs-Tn), MB isoform of creatin kinase (CK-MB), marker of myocardial strain (NT-proBNP) and inflammatory parameters [high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC)] were gathered from medical histories and documentations. Results: Out of 310 patients more than a half (n=172, 55%) were admitted electively. Urgent patients had higher heart rate, NYHA class, and lower left ventricular ejection fraction (EF). Elective ischemic cardiomyopathy (ICM) patients were more likely to be older male with higher EF, and increased level of hs-TnT and CK-MB. As for urgent admissions, the frequency of male sex was similar in both groups but ICM patients were significantly older, had worse kidney function, and increased level of hs-TnT and NT-proBNP than patients with dilated cardiomyopathy (DCM). Conclusions: Systolic HF patients admitted electively and urgently differ significantly. Moreover, patients with different HF etiologies, such as ischemic and dilated cardiomyopathy, admitted either electively or urgently have different profiles. The observed elevation of ischemic and inflammatory parameters in decompensated HF may indicate possible mechanisms of HF worsening, leading to the acute admissions. The true meaning of the observations as well as potential additional anti-inflammatory and/or anti-ischemic treatment in stable HF to prevent acute episodes could a subject for further studies. JRCD 2014; 1 (7): 7–12
McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A; ESC Committee for Practice Guidelines. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012 Jul;33(14):1787-847.
Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD, Buller CE, Jacobs AK, Slater JN, Col J, McKinlay SM, LeJemtel TH. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. N Engl J Med 1999 Aug 26;341(9):625-34
Maisel A, Mueller C, Adams K Jr, Anker SD, Aspromonte N, Cleland JG, Cohen-Solal A, Dahlstrom U, DeMaria A, Di Somma S, Filippatos GS, Fonarow GC, Jourdain P, Komajda M, Liu PP, McDonagh T, McDonald K, Mebazaa A, Nieminen MS, Peacock WF, Tubaro M, Valle R, Vanderhyden M, Yancy CW, Zannad F, Braunwald E. State of the art: using natriuretic peptide levels in clinical practice. Eur J Heart Fail 2008 Sep;10(9):824-39
Rudiger A, Harjola VP, Müller A, Mattila E, Säila P, Nieminen M, Follath F. Acute heart failure: clinical presentation, one-year mortality and prognostic factors. Eur J Heart Fail 2005 Jun;7(4):662-70.
Cohen-Solal A, Damy T, Terbah M, Kerebel S, Baguet JP, Hanon O, Zannad F, Laperche T, Leclercq C, Concas V, Duvillié L, Darné B, Anker S, Mebazaa A. High prevalence of iron deficiency in patients with acute decompensated heart failure. Eur J Heart Fail 2014 Sep;16(9):984-91.
Filippatos G1, Farmakis D, Colet JC, Dickstein K, Lüscher TF, Willenheimer R, Parissis J, Gaudesius G, Mori C, von Eisenhart Rothe B, Greenlaw N, Ford I, Ponikowski P, Anker SD. Intravenous ferric carboxymaltose in iron-deficient chronic heart failure patients with and without anaemia: a subanalysis of the FAIR-HF trial. Eur J Heart Fail 2013 Nov;15(11):1267-76.
Sánchez-Lázaro IJ, Almenar L, Reganon E, Vila V, Martínez-Dolz L, Martínez-Sales V, Moro J, Agüero J, Ortiz-Martínez V, Salvador A. Inflammatory markers in stable heart failure and their relationship with functional class. Int J Cardiol 2008 Oct 13;129(3):388-93.
Biolo A, Fisch M, Balog J, Chao T, Schulze PC, Ooi H, Siwik D, Colucci WS. Episodes of acute heart failure syndrome are associated with increased levels of troponin and extracellular matrix markers. Circ Heart Fail 2010 Jan;3(1):44-50.
Vorovich E, French B, Ky B, Goldberg L, Fang JC, Sweitzer NK, Cappola TP. Biomarker predictors of cardiac hospitalization in chronic heart failure: a recurrent event analysis. J Card Fail 2014 Aug;20(8):569-76
Elliot, Anderson B, Arbustini A, Bilińska Z, Cecchi F, Charron P, Dubourg O, Kuhl U, Maisch B, McKenna WJ, Monserrat L, Pankuweit S, Rapezzi C, Seferovic P, Tavazzi L, and Keren A. Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2007; 29: 270-7.
Miller WL, Hartman KA, Burritt MF, Burnett JC Jr, Jaffe AS. Troponin, B-type natriuretic peptides and outcomes in severe heart failure: differences between ischemic and dilated cardiomyopathies. Clin Cardiol 2007 May;30(5):245-50.
Massie BM, Collins JF, Ammon SE, Armstrong PW, Cleland JG, Ezekowitz M, Jafri SM, Krol WF, O'Connor CM, Schulman KA, Teo K, Warren SR; WATCH Trial Investigators. Randomized trial of warfarin, aspirin, and clopidogrel in patients with chronic heart failure: the Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial. Circulation 2009 Mar 31;119(12):1616-24.
Cleland JG, Mumtaz S, Cecchini L. Role of antithrombotic agents in heart failure. Curr Cardiol Rep 2012 Jun;14(3):314-25.
Gheorghiade M, Vaduganathan M, Fonarow GC, Greene SJ, Greenberg BH, Liu PP, Massie BM, Mehra MR, Metra M, Zannad F, Cleland JG, van Veldhuisen DJ, Shah AN, Butler J. Anticoagulation in heart failure: current status and future direction. Heart Fail Rev 2013 Nov;18(6):797-813
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