- 著者
- Ángel López-Cuenca Sergio Manzano-Fernández Francisco Marín Soledad Parra-Pallares Marina Navarro-Peñalver Salvador Montalban-Larrea Jose M. Andreu-Cayuelas Ana I. Romero-Aniorte Francisco Avilés-Plaza Mariano Valdés-Chavarri James L. Januzzi Jr
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.77, no.8, pp.2088-2096, 2013 (Released:2013-07-25)
- 参考文献数
- 24
- 被引用文献数
- 4 5
Background: Beta-trace protein (BTP) and cystatin C (CysC) are novel biomarkers of renal function. We assessed the ability of both to predict major bleeding (MB) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), compared to other renal function parameters and clinical risk scores. Methods and Results: We included 273 patients. Blood samples were obtained within 24h of admission. The endpoint was MB. During a follow-up of 760 days (411–1,098 days), 25 patients (9.2%) had MB. Patients with MB had higher concentrations of BTP (0.98mg/L; 0.71–1.16mg/L vs. 0.72mg/L, 0.60–0.91mg/L, P=0.002), CysC (1.05mg/L; 0.91–1.30mg/L vs. 0.90mg/L, 0.75–1.08mg/L, P=0.003), higher CRUSADE score (39±16 points vs. 29±15 points, P=0.002) and lower estimated glomerular filtration rate (eGFR; 66±27 vs. 80±30ml·min–1·1.73m–2, P=0.02) than patients without MB; there was no difference in creatinine level between the groups (P=0.14). After multivariable adjustment, both were predictors of MB, while eGFR and creatinine did not achieve statistical significance. Among subjects with eGFR >60ml·min–1·1.73m–2, those with elevated concentrations of both biomarkers had a significantly higher risk for MB. Net reclassification indexes from the addition of BTP and CysC to CRUSADE risk score were 38% and 21% respectively, while the relative integrated discrimination indexes were 12.5% and 3.8%. Conclusions: Among NSTE-ACS patients, BTP and CysC were superior to conventional renal parameters for predicting MB, and improved clinical stratification for hemorrhagic risk. (Circ J 2013; 77: 2088–2096)
- 著者
- Ángel López-Cuenca Sergio Manzano-Fernández Francisco Marín Soledad Parra-Pallares Marina Navarro-Peñalver Salvador Montalban-Larrea Jose M. Andreu-Cayuelas Ana I. Romero-Aniorte Francisco Avilés-Plaza Mariano Valdés-Chavarri James L. Januzzi Jr
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-13-0106, (Released:2013-05-23)
- 参考文献数
- 24
- 被引用文献数
- 4 5
Background: Beta-trace protein (BTP) and cystatin C (CysC) are novel biomarkers of renal function. We assessed the ability of both to predict major bleeding (MB) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), compared to other renal function parameters and clinical risk scores. Methods and Results: We included 273 patients. Blood samples were obtained within 24h of admission. The endpoint was MB. During a follow-up of 760 days (411–1,098 days), 25 patients (9.2%) had MB. Patients with MB had higher concentrations of BTP (0.98mg/L; 0.71–1.16mg/L vs. 0.72mg/L, 0.60–0.91mg/L, P=0.002), CysC (1.05mg/L; 0.91–1.30mg/L vs. 0.90mg/L, 0.75–1.08mg/L, P=0.003), higher CRUSADE score (39±16 points vs. 29±15 points, P=0.002) and lower estimated glomerular filtration rate (eGFR; 66±27 vs. 80±30ml·min–1·1.73m–2, P=0.02) than patients without MB; there was no difference in creatinine level between the groups (P=0.14). After multivariable adjustment, both were predictors of MB, while eGFR and creatinine did not achieve statistical significance. Among subjects with eGFR >60ml·min–1·1.73m–2, those with elevated concentrations of both biomarkers had a significantly higher risk for MB. Net reclassification indexes from the addition of BTP and CysC to CRUSADE risk score were 38% and 21% respectively, while the relative integrated discrimination indexes were 12.5% and 3.8%. Conclusions: Among NSTE-ACS patients, BTP and CysC were superior to conventional renal parameters for predicting MB, and improved clinical stratification for hemorrhagic risk.
- 著者
- Francisco J. Pastor-Pérez Sergio Manzano-Fernández Rebeca Goya-Esteban Domingo A. Pascual-Figal Oscar Barquero-Pérez Jose Luis Rojo-Álvarez Estrella Everss Maria Dolores Martinez Martinez-Espejo Mariano Valdés Chavarri Arcadi García-Alberola
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.76, no.9, pp.2124-2129, 2012 (Released:2012-08-24)
- 参考文献数
- 30
- 被引用文献数
- 3
Background: Abnormalities in autonomic control are a feature of neuroendocrine activation in HF and are responsible for dysregulation of biological rhythms. The purpose was to investigate the presence and the prognostic significance of long-period heart rate (HR) rhythms in heart failure (HF) patients. Methods and Results: In the study, 92 HF patients were enrolled (age 53±14 years and left ventricular ejection fraction [LVEF] 37±10%). A rhythmometric analysis was used to assess the HR rhythms in 7-days (7D) Holter recordings. Rhythms properties were quantified by mesor and amplitude, in beats/min and by acrophase, in hours. Cardiac death or HF decompensation were registered. All patients had 24-h rhythm, 61 patients (77%) had 8-h rhythm, and 66 patients (83%) had 7D rhythm. Twelve patients (15%) experienced events. Among rhythm parameters only 7D median amplitude was different between patients with or without events: 1.1beats/min [0.5–1.5] vs. 2.0beats/min [0.0–3.9], P=0.049 respectively. After multivariate adjustment, LVEF (per 1%, hazard ratio 0.92, 95% confidence interval (CI) 0.87 to 0.98, P=0.01), N-terminal portion of pro-natriuretic hormone type B (per 100pg/ml, hazard ratio 1.036, 95% CI 1.005–1.069, P=0.022), and 7D amplitude of the HR ≤1.71beats/min (hazard ratio 5.4, 95% CI 1.2–34.4, P=0.047) were independent predictors of events. Conclusions: A 7D HR rhythm is present in most patients with HF, and has prognostic significance. (Circ J 2012; 76: 2124–2129)
- 著者
- Francisco J. Pastor-Pérez Sergio Manzano-Fernández Rebeca Goya-Esteban Domingo A. Pascual-Figal Oscar Barquero-Pérez Jose Luis Rojo-Álvarez Estrella Everss Maria Dolores Martinez Martinez-Espejo Mariano Valdés Chavarri Arcadi García-Alberola
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-12-0192, (Released:2012-06-06)
- 参考文献数
- 30
- 被引用文献数
- 3
Background: Abnormalities in autonomic control are a feature of neuroendocrine activation in HF and are responsible for dysregulation of biological rhythms. The purpose was to investigate the presence and the prognostic significance of long-period heart rate (HR) rhythms in heart failure (HF) patients. Methods and Results: In the study, 92 HF patients were enrolled (age 53±14 years and left ventricular ejection fraction [LVEF] 37±10%). A rhythmometric analysis was used to assess the HR rhythms in 7-days (7D) Holter recordings. Rhythms properties were quantified by mesor and amplitude, in beats/min and by acrophase, in hours. Cardiac death or HF decompensation were registered. All patients had 24-h rhythm, 61 patients (77%) had 8-h rhythm, and 66 patients (83%) had 7D rhythm. Twelve patients (15%) experienced events. Among rhythm parameters only 7D median amplitude was different between patients with or without events: 1.1beats/min [0.5–1.5] vs. 2.0beats/min [0.0–3.9], P=0.049 respectively. After multivariate adjustment, LVEF (per 1%, hazard ratio 0.92, 95% confidence interval (CI) 0.87 to 0.98, P=0.01), N-terminal portion of pro-natriuretic hormone type B (per 100pg/ml, hazard ratio 1.036, 95% CI 1.005–1.069, P=0.022), and 7D amplitude of the HR ≤1.71beats/min (hazard ratio 5.4, 95% CI 1.2–34.4, P=0.047) were independent predictors of events. Conclusions: A 7D HR rhythm is present in most patients with HF, and has prognostic significance.