Biomarkers for Prognosis of Ambulatory Chronic Heart Failure Patients

Circulating Biomarkers as Prognostic Indicators of Death in Ambulatory Heart Failure Patients

Biomarkers representing distinct biological domains including neurohormonal, inflammatory, metabolic-nutritional, oxidative-nitrosative and myocardial injury, might alone or in combination provide prognostic information on mortality in heart failure patients with preserved or impaired systolic function.

Upon enrollment in the study, Troponin I (cTn I), BNP, norepinephrine, plasma renin activity, aldosterone, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), soluble receptor of interleukin 2 (sIL-2R), leptin, prealbumin, free malondialdehyde, 15-F2t-isoprostane and protein-bound nitrotyrosine were measured in stable ambulatory, non diabetic, elderly heart failure patients. Patients were followed up until death or study termination (31st January 2009).

Inclusion Criteria:

• symptomatic congestive heart failure lasting at least six months
• reduced exercise tolerance
• impaired or preserved left ventricular ejection fraction
• cardiomegaly

Exclusion Criteria:

• acute infection
• rheumatoid or other autoimmune diseases
• primary cachectic states (cancer, thyroid disease, severe liver disease)
• severe chronic lung disease
• neuromuscular disorders
• myocardial infarction within the previous 20 weeks
• diabetes mellitus
• chronic renal failure (serum creatinine level > 2.0 mg/dl, >177 micromol/L)