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The Influence of Body Mass Index on Clinical Interpretation of Established and Novel Biomarkers in Acute Heart Failure.
Horiuchi, Y U; Wettersten, Nicholas; Vanveldhuisen, Dirk J; Mueller, Christian; Nowak, Richard; Hogan, Christopher; Kontos, Michael C; Cannon, Chad M; Birkhahn, Robert; Vilke, Gary M; Mahon, Niall; Nuñez, Julio; Briguori, Carlo; Duff, Stephen; Murray, Patrick T; Maisel, Alan.
Afiliação
  • Horiuchi YU; Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
  • Wettersten N; Division of Cardiovascular Medicine, San Diego Veterans Affairs Medical Center, San Diego, CA, USA; Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA.
  • Vanveldhuisen DJ; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Mueller C; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
  • Nowak R; Department of Emergency Medicine, Henry Ford Hospital System, Detroit, MI; USA.
  • Hogan C; Division of Emergency Medicine and Acute Care Surgical Services, VCU Medical Center, Virginia Commonwealth University, Richmond, VA, USA.
  • Kontos MC; Division of Cardiology, VCU Medical Center, Virginia Commonwealth University, Richmond, VA.
  • Cannon CM; Department of Emergency Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
  • Birkhahn R; Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY, USA.
  • Vilke GM; Department of Emergency Medicine, University of California, San Diego, La Jolla, CA, USA.
  • Mahon N; School of Medicine, University College Dublin, Dublin, Ireland.
  • Nuñez J; Department of Cardiology, Hospital Clínico Universitario Valencia, INCLIVA, University of Valencia, Valencia, Spain and CIBER in Cardiovascular Diseases, Madrid, Spain.
  • Briguori C; Department of Cardiology, Interventional Cardiology, Mediterranea Cardiocentro, Naples, Italy.
  • Duff S; School of Medicine, University College Dublin, Dublin, Ireland.
  • Murray PT; School of Medicine, University College Dublin, Dublin, Ireland.
  • Maisel A; Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA. Electronic address: asmaisel@gmail.com.
J Card Fail ; 29(8): 1121-1131, 2023 08.
Article em En | MEDLINE | ID: mdl-37127240
ABSTRACT

BACKGROUND:

Body mass index (BMI) is a known confounder for natriuretic peptides, but its influence on other biomarkers is less well described. We investigated whether BMI interacts with biomarkers' association with prognosis in patients with acute heart failure (AHF). METHODS AND

RESULTS:

B-type natriuretic peptide (BNP), high-sensitivity cardiac troponin I (hs-cTnI), galectin-3, serum neutrophil gelatinase-associated lipocalin (sNGAL), and urine NGAL were measured serially in patients with AHF during hospitalization in the AKINESIS (Acute Kidney Injury Neutrophil gelatinase-associated lipocalin Evaluation of Symptomatic Heart Failure) study. Cox regression analysis was used to determine the association of biomarkers and their interaction with BMI for 30-day, 90-day and 1-year composite outcomes of death or HF readmission. Among 866 patients, 21.2%, 29.7% and 46.8% had normal (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) or obese (≥ 30 kg/m2) BMIs on admission, respectively. Admission values of BNP and hs-cTnI were negatively associated with BMI, whereas galectin-3 and sNGAL were positively associated with BMI. Admission BNP and hs-cTnI levels were associated with the composite outcome within 30 days, 90 days and 1 year. Only BNP had a significant interaction with BMI. When BNP was analyzed by BMI category, its association with the composite outcome attenuated at higher BMIs and was no longer significant in obese individuals. Findings were similar when evaluated by the last-measured biomarkers and BMIs.

CONCLUSIONS:

In patients with AHF, only BNP had a significant interaction with BMI for the outcomes, with its association attenuating as BMI increased; hs-cTnI was prognostic, regardless of BMI.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Cardíaca Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Cardíaca Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article