Page 29 - Biomarkers for risk stratification and guidance in heart failure

Chapter 2
Footnote table 1: Values represent mean ± SD, frequency (%), or median (interquartile range). ACEi = angiotensin-converting enzyme inhibitor; ACS = acute coronary syndrome; ADHF = acute decompensated heart failure; ARB = angiotensin II receptor blocker; BP = blood pressure; CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease;
hs-CRP = high-sensitivity C-reactive protein; hs-cTnT = high-sensitivity cardiac troponin T; LVEF = left ventricular ejection fraction; NT-proBNP = N-terminal pro–B-type natriuretic peptide; OAC = oral anticoagulation; PD = pulmonary diseas.
Kaplan-Meier curve plots were estimated and compared by the log-rank test. For time-dependent analysis, data was censored at the time of last contact. Tests were two-sided with a level of significance of P<0.05. Calculations were done using SPSS 16.0 (SPSS inc, Chicago, Illinois, USA) and Sigmaplot 12.0 (Systat Software Inc, Chicago, Illinois, USA).
RESULTS
Baseline characteristics.
Between June 2007 and October 2009, 1,477 patients presented with dyspnea to the ED. One hundred and four patients (7%) were excluded because dyspnea was not their main complaint and 106 (7%) patients were excluded because they required immediate therapeutic action. Of the remaining 1,267 eligible patients, 523 (41%) were admitted during working hours of non participating physicians. In 141 (11%) patients at least one baseline biomarker concentration was missing. Baseline characteristics of the final study population of 603 patients are depicted in table 1. Patients were elderly, with a median age of 75 years, 55% were male, more than one-third had a history of heart failure (HF), and almost one-half had a history of coronary artery disease. A large proportion had cardiovascular risk factors such as hypertension (70%), and diabetes mellitus (29%). Almost 40% had dyspnea at rest at presentation. Final diagnosis at the ED was most commonly acute decompensated heart failure (ADHF, i.e. 57%). A non cardiac diagnosis was made in 28% of the patients and in 15% of patients, no pathology was found.
Eligible patients that were not included (n=664) were younger (72 versus 75 years, P <0.001) compared with included patients, but no difference in gender or final diagnosis was observed. Importantly, patients that were not included due to missing biomarkers (n=141) did not differ regarding age, gender or final diagnosis compared with patients included.
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