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Combination of Biomarkers Promises Early Diagnosis And Improved Treatment For Heart Failure
Heart failure describes a syndrome of symptoms without a single diagnostic test.
But now, two studies suggest that a combination of two biomarkers may improve diagnosis and prognosis, and form the basis of optimal management of patients with heart failure.
The first study in Hull, UK, found that repeatedly measuring the well established biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP), once treatment has been optimized, provides stronger prognostic information than either the baseline value, the change in NT-proBNP, or other conventional methods of assessment.
The study involved 354 patients with chronic heart failure treated in a community-based heart failure program.
Indeed, NT-proBNP "was consistently the strongest independent prognostic marker at predicting death or unplanned cardiovascular hospitalizations after baseline or follow-up assessment," said the authors.
"NT-proBNP monitoring will enable the identification of patients who are not responding well to treatment or help flag those patients needing more aggressive management and monitoring," said first author Dr. Milos Kubanek from Castle Hill Hospital, Hull, UK.
"We found NT-proBNP to be a much stronger predictor of mortality and CV-hospitalization than echocardiographic measurements of, for example, ejection fraction, and therefore repeat NT-proBNP measurement may enable a reduction in the number of repeat echocardiograms.
"We suggest that the main role of conventional echocardiography should be to diagnose and differentiate the principal causes of heart failure, with subsequent NT-proBNP monitoring used to identify worsening disease and trigger further echocardiographic assessment. Given the relatively high cost of echocardiography compared to NT-proBNP, such a policy is likely to be cost effective," Kubanek added.
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More News on: Congenital Heart Disease, Heart, Healthy Heart , Lifestyle Paths to Heart Disease, Statins, Mitral Valve Prolapse, Aortic Valve Stenosis
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