Evaluating three biomarkers as prognostic factors of in-hospital mortality and severity in heart failure: A prospective cohort

Pedro A. Segura-Saldaña, Diego Chambergo-Michilot, Javier E. Alarcón-Santos, Cristian Aguilar, Mayita L. Alvarez-Vargas, Marcos Padilla-Reyes, Rodrigo Leon-Vivar, Marcos Pariona-Javier

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Abstract

Objective: To identify the relationship between red blood cell distribution width (RDW, %), interleukin-6 (IL-6) (pg/ml), high sensitivity-c-reactive protein (hs-CRP) (mg/l), in-hospital mortality and disease severity among patients with heart failure (HF). Methods: Prospective cohort. We included adults diagnosed with acute non-ischemic HF in 2015. The dependent variables were in-hospital mortality (yes or no) and disease severity. The latter was assessed with the Get With The Guidelines-HF score. We used hierarchical regression models to describe the pattern of association between biomarkers, mortality, and severity. We used the Youden index to identify the best cut-off for mortality prediction. Results: We included 167 patients; the mean age was 72.61 (SD: 11.06). The majority of patients presented with New York Heart Association classification II (40.12%) or III (43.11%). After adjusting for age and gender, all biomarkers were associated with mortality. After adding comorbidities, only IL-6 was associated. The final model with all clinical variables showed no effect from any biomarker. The best cut-off for RDW, hs-CRP and IL-6 for mortality were 14.8, 68.7 and 52.9, respectively. IL-6 presented the highest sensitivity (100%), specificity (75.35%) and area under the curve (0.91). Conclusions: No biomarker is independent from the most important clinical variables; therefore it should not be used for management modifications.

Original languageEnglish
Pages (from-to)31-40
Number of pages10
JournalRevista Portuguesa de Cardiologia
Volume41
Issue number1
DOIs
StatePublished - Jan 2022

Keywords

  • Biomarkers
  • C-reactive protein
  • Erythrocyte count
  • Heart failure
  • Interleukin-6
  • Mortality

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