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Temporal evolution of liver function parameters predicts clinical outcome in chronic heart failure patients (Bio-SHiFT study).
Klimczak-Tomaniak, Dominika; Andrzejczyk, Karolina; Abou Kamar, Sabrina; Baart, Sara; van Boven, Nick; Akkerhuis, K Martijn; Constantinescu, Alina; Caliskan, Kadir; Simsek, Suat; Germanse, Tjeerd; van Ramshorst, Jan; Brugts, Jasper; Kuch, Marek; Umans, Victor; Boersma, Eric; Kardys, Isabella.
Afiliación
  • Klimczak-Tomaniak D; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Andrzejczyk K; Department of Cardiology, Hypertension and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
  • Abou Kamar S; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Baart S; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • van Boven N; Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Akkerhuis KM; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Constantinescu A; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Caliskan K; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Simsek S; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Germanse T; Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands.
  • van Ramshorst J; Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands.
  • Brugts J; Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands.
  • Kuch M; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  • Umans V; Department of Cardiology, Hypertension and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
  • Boersma E; Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands.
  • Kardys I; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Cardiol J ; 31(3): 409-417, 2024.
Article en En | MEDLINE | ID: mdl-38408202
ABSTRACT

BACKGROUND:

Liver dysfunction contributes to worse clinical outcomes in heart failure (HF) patients. However, studies exploring temporal evolutions of liver function parameters in chronic HF (CHF) pa- tients, and their associations with clinical outcome, are scarce. Detailed temporal patterns of alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGTP), total bilirubin (TBIL) and albumin (ALB) were investigated, and their relation with clinical outcome, in patients with stable CHF with reduced ejection fraction.

METHODS:

Tri-monthly plasma samples were collected from 250 patients during 2.2 (1.4-2.5) years of follow-up. ALP, GGTP, ALB, and TBIL were measured in 749 selected samples and the relationship between repeatedly measured biomarker levels and the primary endpoint (PEP; composite of cardiovas- cular death, heart transplantation, left ventricular assist device implantation, and hospitalization for worsened HF) was evaluated by joint models.

RESULTS:

Mean age was 66 ± 13 years; 74% were men, 25% in New York Heart Association class III-IV. 66 (26%) patients reached the PEP. Repeatedly measured levels of TBIL, ALP, GGTP, and ALB were associated with the PEP after adjustment for N-terminal prohormone B-type natriuretic peptide and high sensitivity troponin T (hazard ratio [95% confidence interval] per doubling of biomarker level 1.98 [1.32; 2.95], p = 0.002; 1.84 [1.09; 3.05], p = 0.018, 1.33 [1.08; 1.63], p = 0.006 and 1.14 [1.09; 1.20], p < 0.001, respectively). Serial levels of ALP and GGTP, and slopes of the temporal evolutions of ALB and TBIL, adjusted for clinical variables, were also significantly associated with the PEP.

CONCLUSIONS:

Changes in serum levels of TBIL, ALP, GGTP, and ALB precede adverse cardiovascular events in patients with CHF. These routine liver function parameters may provide additional prognostic information in heart failure with reduced ejection fraction patients in clinical practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Biomarcadores / Insuficiencia Cardíaca / Pruebas de Función Hepática Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiol J Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Polonia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Biomarcadores / Insuficiencia Cardíaca / Pruebas de Función Hepática Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiol J Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Polonia