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|Title:||Plasma growth hormone is a strong predictor of risk at 1 year in acute heart failure|
|Authors:||Bhandari, Sanjay S.|
Jones, Donald J.L.
Squire, Iain B.
Ng, Leong Loke
|Publisher:||European Society of Cardiology|
|Citation:||European Journal of Heart Failure, 2015 (Early View)|
|Abstract:||AIMS: We sought to compare the prognostic utility of growth hormone (GH) with NT-proBNP) and the ADHERE score in a large cohort of acute heart failure (HF) patients, subcategorized into HF with reduced EF <50% (HFrEF) and preserved EF ≥50% (HFpEF). METHODS AND RESULTS: GH and NTproBNP levels were measured in 537 patients (HFrEF n = 415; HFpEF n = 122) with acute HF recruited into this prospective cohort study. The main outcome measure was death or HF readmission at 1 year. GH levels were higher in both HFrEF [1.26 (0.54-2.62) vs. 0.8 (0.26-1.94) ng/mL, P < 0.001] and HFpEF [1.04 (0.48-2.92) vs. 0.53 (0.18-1.94) ng/mL, P = 0.020] patients with the outcome compared with event-free survivors. GH levels were independently predictive for the outcome at 1 year in the entire cohort [HR 1.47, 95% confidence interval (CI) 1.16-1.86, P = 0.001] and those with HFrEF (HR 1.54, 95% CI 1.19-1.99, P = 0.001) in multivariate Cox hazard analysis. GH improved risk classification as measured by continuous net reclassification improvement (NRI) when added to the ADHERE multivariate logistic model of age, sex, urea, heart rate, and systolic blood pressure, for all patients [NRI 29.6 (12.1-47.1), P = 0.001] and HFrEF NRI 21.7 (1.9-41.6), P = 0.034] patients, as well as in addition to the ADHERE model combined with NT-proBNP for all patients [NRI 25.4 (7.8-43.1), P = 0.005]. CONCLUSION: GH offers incremental prognostic information over the ADHERE score clinical predictors and NT-proBNP for risk stratification of acute HF patients.|
|Rights:||Copyright © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology. All rights reserved. This is the peer reviewed version of the following article: Bhandari, S. S., Narayan, H., Jones, D. J.L., Suzuki, T., Struck, J., Bergmann, A., Squire, I. B. and Ng, L. L. (2015), Plasma growth hormone is a strong predictor of risk at 1 year in acute heart failure. European Journal of Heart Failure, which has been published in final form at dx.doi.org/10.1002/ejhf.459. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.|
|Description:||The file associated with this record is under a 12-month embargo from publication in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.|
|Appears in Collections:||Published Articles, Dept. of Cardiovascular Sciences|
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|revised manuscript_clean_Oct 2015.doc||Post-review (final submitted)||437.5 kB||Microsoft Word||View/Open|
|revised manuscript_clean_Oct 2015.pdf||Post-review (final submitted)||521.47 kB||Adobe PDF||View/Open|
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