Laboratory indicators of pathological changes in patients with chronic heart failure with metabolic syndrome
A P Roytman1, N A Sedova1,2, M A Godkov1,3
1FGBOU DPO «Russian medical Academy of continuing professional education of the Ministry of health of the Russian Federation».
Insights
Metabolic syndrome (MS) worsens chronic heart failure (CHF) outcomes. Elevated NT-proBNP, ST-2, and CRP markers, when ranked, predict CHF prognosis and mortality risk in patients with MS.
Area of Science:
- Cardiology
- Biomarkers
- Metabolic Syndrome
Background:
- Metabolic syndrome (MS) is a significant risk factor for cardiovascular diseases, including chronic heart failure (CHF).
- Understanding the interplay of specific biomarkers in CHF patients with MS is crucial for prognosis.
Purpose of the Study:
- To investigate the levels and correlations of NT-proBNP, ST-2, and CRP in CHF patients with and without MS.
- To assess the utility of these markers, when ranked, in predicting CHF outcomes.
Main Methods:
- Comparative analysis of NT-proBNP, ST-2, and CRP levels in two groups: CHF without MS (n=37) and CHF with MS (n=37).
- Patient stratification based on a composite rank of biomarker concentrations.
- Correlation analysis between biomarkers and patient outcomes (mortality, improvement).
Main Results:
- Patients with CHF and MS showed higher average levels of ST-2 and CRP compared to those without MS.
- A higher proportion of CHF patients with MS (59%) had elevated biomarker ranks (6-9) versus those without MS (38%).
- Elevated biomarker ranks (6-9) were strongly associated with mortality (17/18 deaths) and less so with improvement in CHF patients.
Conclusions:
- The combination and ranking of NT-proBNP, ST-2, and CRP levels offer valuable prognostic information in CHF.
- These ranked biomarkers can help identify CHF patients at higher risk of adverse outcomes, particularly those with co-existing metabolic syndrome.
Abstract:
The presence of metabolic syndrome (MS) significantly increases the risk of developing cardiovascular diseases that lead to chronic heart failure (CHF). The values of NT-proBNP, ST-2, and CRP markers and their mutual correlations were studied in 37 patients with chronic heart failure (CHF) without metabolic syndrome (MS) (group 1) and 37 patients with CHF with MS (group 2). The aim of the study was to determine the features of their changes in patients with CHF complicated by MS, and to rank patients by assigning a rank value to the values of NTproBNP, ST2, and CRP concentrations. The average ST2 level was 51±24 ng/ml in group 1 and 62±27 ng/ml in group 2. The average values of CRP in group 1 were 23.1±5.3 mg/l, in group 2-33.0±4.4 mg/l (p<0.05). The NTproBNP level was 2413±1586 PG/ml and 2721±1635 PG/ml in groups 1 and 2, respectively. Correlations between the values of NTproBNP and ST2, NTproBNP and CRP were demonstrated. In the group of CHF with MS, compared with the group of CHF, there were significantly more patients with the most pronounced pathological levels of damage markers: the number of patients with a General rank of 6-9 in the group of CHF with MS was 59%, in the group of CHF without MS-38% (p<0.05). Of the 18 patients who died, 17 were among those who had an overall rank of 6 to 9, only 1 patient who died after hospitalization had an overall rank of 5. At the same time, among 22 patients who had improved CHF in the outcome of hospitalization, 18 patients had a total rank from 0 to 5, and in 4 patients of this category, the clinical manifestations of CHF remained virtually unchanged. The results of ranking the level of the studied laboratory markers indicate that they can be used as a predictor of various outcomes of CHF.
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