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Int. J. Mol. Sci. 2015, 16(5), 10715-10733; doi:10.3390/ijms160510715

The Multi-Biomarker Approach for Heart Failure in Patients with Hypertension

1
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland
2
Department of Nephrology, Hypertension and Family Medicine, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland
3
Chair of Statistical Methods, Faculty of Economics and Sociology, University of Lodz, Rewolucji 1905/41, 90-214 Lodz, Poland
These authors contributed equally to this work.
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: H. W. M. Niessen
Received: 18 February 2015 / Revised: 21 April 2015 / Accepted: 23 April 2015 / Published: 12 May 2015
(This article belongs to the Special Issue Improvement of Cardiac Function in Heart Failure)
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Abstract

We assessed the predictive ability of selected biomarkers using N-terminal pro-brain natriuretic peptide (NT-proBNP) as the benchmark and tried to establish a multi-biomarker approach to heart failure (HF) in hypertensive patients. In 120 hypertensive patients with or without overt heart failure, the incremental predictive value of the following biomarkers was investigated: Collagen III N-terminal propeptide (PIIINP), cystatin C (CysC), lipocalin-2/NGAL, syndecan-4, tumor necrosis factor-α (TNF-α), interleukin 1 receptor type I (IL1R1), galectin-3, cardiotrophin-1 (CT-1), transforming growth factor β (TGF-β) and N-terminal pro-brain natriuretic peptide (NT-proBNP). The highest discriminative value for HF was observed for NT-proBNP (area under the receiver operating characteristic curve (AUC) = 0.873) and TGF-β (AUC = 0.878). On the basis of ROC curve analysis we found that CT-1 > 152 pg/mL, TGF-β < 7.7 ng/mL, syndecan > 2.3 ng/mL, NT-proBNP > 332.5 pg/mL, CysC > 1 mg/L and NGAL > 39.9 ng/mL were significant predictors of overt HF. There was only a small improvement in predictive ability of the multi-biomarker panel including the four biomarkers with the best performance in the detection of HF—NT-proBNP, TGF-β, CT-1, CysC—compared to the panel with NT-proBNP, TGF-β and CT-1 only. Biomarkers with different pathophysiological backgrounds (NT-proBNP, TGF-β, CT-1, CysC) give additive prognostic value for incident HF in hypertensive patients compared to NT-proBNP alone. View Full-Text
Keywords: hypertension; biomarkers; heart failure hypertension; biomarkers; heart failure
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MDPI and ACS Style

Bielecka-Dabrowa, A.; Gluba-Brzózka, A.; Michalska-Kasiczak, M.; Misztal, M.; Rysz, J.; Banach, M. The Multi-Biomarker Approach for Heart Failure in Patients with Hypertension. Int. J. Mol. Sci. 2015, 16, 10715-10733.

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