Abstract:
BACKGROUND:The diuretic response has been shown to be a robust independent marker of cardiovascular outcomes in acute heart failure (ADHF) patients. The objectives of this clinical research, will aim are to: a) include diuresis in the formula for diuretic response (R-to-D); b) add to R-to-D the value of a pre-discharged determination of galectin-3 and BNP in predicting mid-term clinical outcome. METHODS:Consecutive patients discharged alive after an ADHF were enrolled. All patients underwent BNP and galectin-3, a 6 min walk test and an echocardiogram together with diuresis and body weight during diuretic administration. Death by any cause, cardiac transplantation and worsening HF requiring readmission to the hospital were considered cardiovascular events. RESULTS:141 patients (98 males, age 73.8) were analysed (follow-up 17 months). During the follow-up 45 (31.9%) events were scheduled (19 cardiac deaths, 26 re-hospitalisation for HF). Patients who experienced CV-event had a worst renal function (p = 0.003), an higher BNP (p = 0.006) and galectin-3 (p = 0.008). At multivariate analysis, only R-to-D, galectin-3 and BNP showed a significant correlation with worst clinical prognosis (respectively p = 0.043; OR 6.01; p = 0.01; OR 8.9; p = 0.02 OR 10.38), independently of age and renal function. Kaplan-Meier curves depicted a powerful stratification using an R-to-D <1.2 kg/40 mg furosemide (log rank 10.96; p = 0.0009). Adding R-to-D<1.2 mg/40 mg furosemide to galectin-3>17.6 pg/mL and BNP>500 pg/mL the predictive value improved (log rank 23.59; p = 0.0001). CONCLUSION:Adding R-to-D to Gal-3 and BNP, a single pre-discharge strategy testing seemed to obtain a satisfactorily predictive value in alive HF patients discharged after an ADHF episode.
journal_name
Arch Med Resjournal_title
Archives of medical researchauthors
Feola M,Testa M,Ferreri C,Cardone M,Sola M,Ariotti S,Rosso GLdoi
10.1016/j.arcmed.2018.08.007subject
Has Abstractpub_date
2018-04-01 00:00:00pages
198-204issue
3eissn
0188-4409issn
1873-5487pii
S0188-4409(18)30452-1journal_volume
49pub_type
杂志文章abstract:BACKGROUND AND AIMS:Previous published data have implicated TP53 codon 72 polymorphisms as risk factors for various cancers. Growing bodies of studies have been conducted on the association of TP53 codon 72 polymorphisms with susceptibility to oral carcinoma and have yielded inconclusive results. The aim of the present...
journal_title:Archives of medical research
pub_type: 杂志文章,meta分析
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journal_title:Archives of medical research
pub_type: 临床试验,杂志文章
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abstract::Genetic alterations in tumors, as predictor of response to targeted-therapies or as prognostic markers, are clinically relevant to determine adequate therapeutic management. Tumor biopsy is currently the golden standard for somatic alterations assessment, but this approach is invasive and does not consider tumor heter...
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更新日期:2008-02-01 00:00:00
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pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2003-11-01 00:00:00
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doi:
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pub_type: 杂志文章
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更新日期:2007-10-01 00:00:00