Document Detail

Serum beta2-microglobulin concentration as a novel marker to distinguish levels of risk in acute heart failure patients.
MedLine Citation:
PMID:  20122555     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-25
Journal Detail:
Title:  Journal of cardiology     Volume:  55     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  99-107     Citation Subset:  IM    
Copyright Information:
2009 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Department of Internal Medicine, Kasai City Hospital, 1-13, Yoko-o, Hojo-cho, Kasai, Hyogo 675-2311, Japan.
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MeSH Terms
Biological Markers / blood*
Blood Pressure
Body Mass Index
Creatinine / blood,  metabolism
Glomerular Filtration Rate
Heart Failure / blood,  mortality*
Pulmonary Disease, Chronic Obstructive / complications
beta 2-Microglobulin / blood*
Reg. No./Substance:
0/Biological Markers; 0/beta 2-Microglobulin; 60-27-5/Creatinine; 69049-73-6/Nedocromil

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