Mid-region pro-hormone markers for diagnosis and prognosis in acute dyspnea : results from the BACH (Biomarkers in Acute Heart Failure) trial
作者： Alan Maisel , Christian Mueller , Richard Nowak , W. Frank Peacock , Judd W. Landsberg
DOI: 10.1016/J.JACC.2010.02.025
关键词:
摘要: Objectives Our purpose was to assess the diagnostic utility of mid-regional pro–atrial natriuretic peptide (MR-proANP) for diagnosis acute heart failure (AHF) and prognostic value pro-adrenomedullin (MR-proADM) in patients with AHF. Background There are some caveats limitations testing dyspneic patient. Methods The BACH (Biomarkers Acute Heart Failure) trial a prospective, 15-center, international study 1,641 presenting emergency department dyspnea. A noninferiority test MR-proANP versus B-type (BNP) AHF superiority MR-proADM BNP 90-day survival were conducted. Other end points exploratory. Results (≥120 pmol/l) proved noninferior (≥100 pg/ml) (accuracy difference 0.9%). In tests secondary objectives, levels added intermediate values obesity but not renal insufficiency, elderly, or edema. Using cut-off from receiver-operating characteristic analysis, accuracy predict 73% (95% confidence interval: 70% 77%) 62% 58% 66%) (difference p Conclusions is as useful may provide additional clinical when difficult interpret. identifies high mortality risk adds BNP. Failure [BACH]; NCT00537628)
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