| Serum beta2-microglobulin concentration as a novel marker to distinguish levels of risk in acute heart failure patients. | |
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MedLine Citation:
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PMID: 20122555 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults. However, the prognostic role of beta2-microglobulin in heart failure has not been elucidated. METHODS: We prospectively evaluated serum beta2-microglobulin and creatinine concentrations, creatinine-based renal parameters (estimated glomerular filtration rate and creatinine clearance), and echocardiographic data in 131 patients with acute heart failure and creatinine concentrations < or =3.0mg/dL admitted to our hospitals. RESULTS: During 2.3+/-1.3 years, 42 patients died of cardiovascular causes and 12 died of noncardiac causes. Cardiovascular events were observed in 63 patients: 53 were readmitted due to worsening heart failure, 5 readmitted for cerebral embolism, and 5 died from sudden cardiac death. According to multivariate stepwise Cox proportional hazard analysis, higher baseline serum beta2-microglobulin concentrations (X(2)=16, p<0.0001), previous congestive heart failure (X(2)=11, p<0.001), presence of chronic obstructive pulmonary disease (X(2)=8, p<0.01), and lower diastolic blood pressure (X(2)=6, p<0.05) were independent predictors of increased cardiovascular events. Also, higher baseline serum beta2-microglobulin (X(2)=20, p<0.0001), lower systolic blood pressure (X(2)=11, p<0.001), higher relative left ventricular wall thickness (X(2)=6, p<0.05), and lower body mass index (X(2)=5, p<0.05) were independent predictors of increased cardiac mortality. The adjusted hazard ratio for cardiovascular events increased with baseline serum beta2-microglobulin above 2.1 mg/L: 2.9 with beta2-microglobulin of 2.2-2.6 mg/L (95%CI 1.2-6.9, p<0.05), 2.9 with beta2-microglobulin of 2.7-3.9 mg/L (95%CI 1.2-7.2, p<0.05), and 4.7 with beta2-microglobulin of > or =4.0 mg/L (95%CI 2.0-11, p<0.001). CONCLUSIONS: Higher baseline serum beta2-microglobulin concentration could be a promising risk marker in acute heart failure patients with creatinine < or =3.0 mg/dL. |
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Authors:
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Keisuke Kawai; Seinosuke Kawashima; Toshiyuki Miyazaki; Eiichi Tajiri; Masuki Mori; Kazuhisa Kitazaki; Tomohiko Shirotani; Tetsuya Inatome; Hiroshi Yamabe; Ken-Ichi Hirata; Mitsuhiro Yokoyama |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-11-25 |
Journal Detail:
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Title: Journal of cardiology Volume: 55 ISSN: 0914-5087 ISO Abbreviation: J Cardiol Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-02-03 Completed Date: 2010-08-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804703 Medline TA: J Cardiol Country: Japan |
Other Details:
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Languages: eng Pagination: 99-107 Citation Subset: IM |
Copyright Information:
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2009 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Internal Medicine, Kasai City Hospital, 1-13, Yoko-o, Hojo-cho, Kasai, Hyogo 675-2311, Japan. kkawai@river.sannet.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers / blood* Blood Pressure Body Mass Index Creatinine / blood, metabolism Echocardiography Female Glomerular Filtration Rate Heart Failure / blood, mortality* Humans Male Nedocromil Prognosis Pulmonary Disease, Chronic Obstructive / complications Recurrence beta 2-Microglobulin / blood* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/beta 2-Microglobulin; 60-27-5/Creatinine; 69049-73-6/Nedocromil |
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