Prognosis of new‐onset heart failure outpatients and collagen biomarkers. (14th July 2015)

• Record Type: Journal Article
• Authors: Sanchis, Laura; Andrea, Rut; Falces, Carles; Llopis, Jaume; Morales‐Ruiz, Manuel; López‐Sobrino, Teresa; Pérez‐Villa, Félix; Sitges, Marta; Sabate, Manel; Brugada, Josep
• Is Part Of: European journal of clinical investigation. Volume 45:Number 8(2015:Aug.)
• Page Start: 842
• Page End: 849
• Publication Date: 2015-07-14
• Subjects: Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12479
• Languages: English
• ISSNs: 0014-2972

Abstract

<abstract abstract-type="main" id="eci12479-abs-0001"> <title>Abstract</title> <sec id="eci12479-sec-0001" sec-type="section"> <title>Background</title> <p>Prognosis of heart failure patients has been defined in hospital‐based or retrospective studies. This study aimed to characterize prognosis of outpatients with new‐onset preserved or reduced ejection fraction heart failure; to explore the role of collagen turnover biomarkers (MMP2, MMP9, TIMP1) in predicting prognosis; and to analyse their relationship with echocardiographic parameters and final diagnosis.</p> </sec> <sec id="eci12479-sec-0002" sec-type="section"> <title>Methods</title> <p>This is an observational, prospective, longitudinal study. Outpatients with new‐onset heart failure symptoms referred to a one‐stop clinic were included. Echocardiography and biomarkers plasma levels determination were performed at the inclusion. A prospective follow‐up was conducted to report cardiovascular events. The discriminant analysis was applied to identify the parameters related to cardiovascular outcomes.</p> </sec> <sec id="eci12479-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 172 patients (75 ± 9 years) were included, 67% with heart failure (64% preserved and 36% with reduced ejection fraction). During follow‐up (median 34·5 months), 32·6% had at least one cardiovascular event and 9·9% died. Heart failure groups showed no differences in cardiovascular outcomes with a higher rate of events than nonheart failure patients. MMP2 and TIMP1 were correlated with diastolic dysfunction (Rho 0·349 and 0·294, <italic>P</italic> < 0·001). In the discriminant analysis, the combination of biomarkers with clinical, biochemical and echocardiographic parameters was useful to predict cardiovascular outcomes (AUC ROC 0·806, Wilks lambda 0·7688, <italic>P</italic> < 0·001).</p> </sec> <sec id="eci12479-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Prognosis of outpatients with new‐onset heart failure symptoms is comparable between heart failure with preserved or reduced subgroups. The addition of biomarkers specially MMP2 and high sensitive troponin I to other clinical, biochemical and echocardiographic variables can predict cardiovascular prognosis at the time of diagnosis.</p> </sec> </abstract>