Plasma chromograninx: Plasma chromogranin A is a marker of death in elderly patients presenting with symptoms of heart failure
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Plasma chromograninx : Plasma chromogranin A is a marker of death in elderly patients presenting with symptoms of heart failure. / Goetze, Jens P; Hilsted, Linda M; Rehfeld, Jens F; Alehagen, Urban.
In: Endocrine Connections, Vol. 3, No. 1, 2014, p. 47-56.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Plasma chromograninx
T2 - Plasma chromogranin A is a marker of death in elderly patients presenting with symptoms of heart failure
AU - Goetze, Jens P
AU - Hilsted, Linda M
AU - Rehfeld, Jens F
AU - Alehagen, Urban
PY - 2014
Y1 - 2014
N2 - Cardiovascular risk assessment remains difficult in elderly patients. We examined whether chromogranin A (CgA) measurement in plasma may be valuable in assessing risk of death in elderly patients with symptoms of heart failure in a primary care setting. A total of 470 patients (mean age 73 years) were followed for 10 years. For CgA plasma measurement, we used a two-step method including a screening test and a confirmative test with plasma pre-treatment with trypsin. Cox multivariable proportional regression and receiver-operating curve (ROC) analyses were used to assess mortality risk. Assessment of cardiovascular mortality during the first 3 years of observation showed that CgA measurement contained useful information with a hazard ratio (HR) of 5.4 (95% CI 1.7-16.4) (CgA confirm). In a multivariate setting, the corresponding HR was 5.9 (95% CI 1.8-19.1). WHEN ADDING N-TERMINAL PROBNP (NT-PROBNP) TO THE MODEL, CGA CONFIRM STILL POSSESSED PROGNOSTIC INFORMATION (HR: 6.1; 95% CI 1.8-20.7). The result for predicting all-cause mortality displayed the same pattern. ROC analyses in comparison to NT-proBNP to identify patients on top of clinical variables at risk of cardiovascular death within 5 years of follow-up showed significant additive value of CgA confirm measurements compared with NT-proBNP and clinical variables. CgA measurement in the plasma of elderly patients with symptoms of heart failure can identify those at increased risk of short- and long-term mortality.
AB - Cardiovascular risk assessment remains difficult in elderly patients. We examined whether chromogranin A (CgA) measurement in plasma may be valuable in assessing risk of death in elderly patients with symptoms of heart failure in a primary care setting. A total of 470 patients (mean age 73 years) were followed for 10 years. For CgA plasma measurement, we used a two-step method including a screening test and a confirmative test with plasma pre-treatment with trypsin. Cox multivariable proportional regression and receiver-operating curve (ROC) analyses were used to assess mortality risk. Assessment of cardiovascular mortality during the first 3 years of observation showed that CgA measurement contained useful information with a hazard ratio (HR) of 5.4 (95% CI 1.7-16.4) (CgA confirm). In a multivariate setting, the corresponding HR was 5.9 (95% CI 1.8-19.1). WHEN ADDING N-TERMINAL PROBNP (NT-PROBNP) TO THE MODEL, CGA CONFIRM STILL POSSESSED PROGNOSTIC INFORMATION (HR: 6.1; 95% CI 1.8-20.7). The result for predicting all-cause mortality displayed the same pattern. ROC analyses in comparison to NT-proBNP to identify patients on top of clinical variables at risk of cardiovascular death within 5 years of follow-up showed significant additive value of CgA confirm measurements compared with NT-proBNP and clinical variables. CgA measurement in the plasma of elderly patients with symptoms of heart failure can identify those at increased risk of short- and long-term mortality.
U2 - 10.1530/EC-14-0017
DO - 10.1530/EC-14-0017
M3 - Journal article
C2 - 24532383
VL - 3
SP - 47
EP - 56
JO - Endocrine Connections
JF - Endocrine Connections
SN - 2049-3614
IS - 1
ER -
ID: 138816992