論文

国際誌
2021年8月13日

Combined Assessment of D-Dimer with the Get with the Guidelines-Heart Failure Risk Score and N-Terminal Pro-B-Type Natriuretic Peptide in Patients with Acute Decompensated Heart Failure with Preserved and Reduced Ejection Fraction.

Journal of clinical medicine
  • Hiroyuki Naruse
  • ,
  • Junnichi Ishii
  • ,
  • Hiroshi Takahashi
  • ,
  • Fumihiko Kitagawa
  • ,
  • Eirin Sakaguchi
  • ,
  • Hideto Nishimura
  • ,
  • Hideki Kawai
  • ,
  • Takashi Muramatsu
  • ,
  • Masahide Harada
  • ,
  • Akira Yamada
  • ,
  • Wakaya Fujiwara
  • ,
  • Mutsuharu Hayashi
  • ,
  • Sadako Motoyama
  • ,
  • Masayoshi Sarai
  • ,
  • Eiichi Watanabe
  • ,
  • Hiroyasu Ito
  • ,
  • Yukio Ozaki
  • ,
  • Hideo Izawa

10
16
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3390/jcm10163564

The prognostic role of D-dimer in different types of heart failure (HF) is poorly understood. We investigated the prognostic value of D-dimer on admission, both independently and in combination with the Get With The Guidelines-Heart Failure (GWTG-HF) risk score and N-terminal pro-B-type natriuretic peptide (NT-proBNP), in patients with preserved left ventricular ejection fraction (LVEF) and acute decompensated HF (HFpEF) or reduced LVEF (HFrEF). Baseline D-dimer levels were measured on admission in 1670 patients (mean age: 75 years) who were hospitalized for worsening HF. Of those patients, 586 (35%) were categorized as HFpEF (LVEF ≥ 50%) and 1084 as HFrEF (LVEF < 50%). During the 12-month follow-up period after admission, 360 patients died. Elevated levels (at least the highest tertile value) of D-dimer, GWTG-HF risk score, and NT-proBNP were all independently associated with mortality in all HFpEF and HFrEF patients (all p < 0.05). Adding D-dimer to a baseline model with a GWTG-HF risk score and NT-proBNP improved the net reclassification and integrated discrimination improvement for mortality greater than the baseline model alone in all populations (all p < 0.001). The number of elevations in D-dimer, GWTG-HF risk score, and NT-proBNP were independently associated with a higher risk of mortality in all study populations (HFpEF and HFrEF patients; all p < 0.001). The combination of D-dimer, which is independently predictive of mortality, with the GWTG-HF risk score and NT-proBNP could improve early prediction of 12-month mortality in patients with acute decompensated HF, regardless of the HF phenotype.

リンク情報
DOI
https://doi.org/10.3390/jcm10163564
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34441860
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396840
ID情報
  • DOI : 10.3390/jcm10163564
  • PubMed ID : 34441860
  • PubMed Central 記事ID : PMC8396840

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