Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
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PMID:Plasma chromogranin A is a marker of death in elderly patients presenting with symptoms of heart failure. 2453 83

Each new troponin assay generation is more sensitive, with recent generation high-sensitivity troponin (hsTn) assays able to detect minimal myocardial injury, even in asymptomatic patients. PURPOSE OF THE REVIEW: We reviewed recent information on the use of hsTn assays for assessing acute and chronic cardiovascular disease. RECENT FINDINGS: hsTn is used for early emergency department diagnosis, accelerating early discharge with a low event rate comparable if not better than current strategies. Low levels of hsTn are detected in a variety of chronic cardiac and non-cardiac conditions, non-disease conditions including heart failure, chemotherapy, and others. These elevations identify a population at increased risk for long-term cardiovascular events. However, management strategies remain unclear. hsTn has substantial advantages in emergency department use. They hold promise for identifying subclinical cardiac disease, with the potential for earlier intervention with the possibility of decreasing disease progression. Additional studies, however, are needed to determine if this strategy will lead to improved outcomes.
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PMID:High-Sensitivity Troponins in Cardiovascular Disease. 3223 71


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