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Plasma chromogranin A is a marker of death in elderly patients presenting with symptoms of heart failure
Rigshospitalet, University of Copenhagen, Denmark .
Rigshospitalet, University of Copenhagen, Denmark .
Rigshospitalet, University of Copenhagen, Denmark .
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
2014 (English)In: Endocrine Connections, ISSN 2049-3614, E-ISSN 2049-3614, Vol. 3, no 1, 47-56 p.Article in journal (Refereed) Published
Abstract [en]

Cardiovascular risk assessment remains difficult in elderly patients. We examined whether chromogranin A (CgA) measurement in plasma may be valuable in assessing risk of death in elderly patients with symptoms of heart failure in a primary care setting. A total of 470 patients (mean age 73 years) were followed for 10 years. For CgA plasma measurement, we used a two-step method including a screening test and a confirmative test with plasma pre-treatment with trypsin. Cox multivariable proportional regression and receiver-operating curve (ROC) analyses were used to assess mortality risk. Assessment of cardiovascular mortality during the first 3 years of observation showed that CgA measurement contained useful information with a hazard ratio (HR) of 5.4 (95% CI 1.7–16.4) (CgA confirm). In a multivariate setting, the corresponding HR was 5.9 (95% CI 1.8–19.1). When adding N-terminal proBNP (NT-proBNP) to the model, CgA confirm still possessed prognostic information (HR: 6.1; 95% CI 1.8–20.7). The result for predicting all-cause mortality displayed the same pattern. ROC analyses in comparison to NT-proBNP to identify patients on top of clinical variables at risk of cardiovascular death within 5 years of follow-up showed significant additive value of CgA confirm measurements compared with NT-proBNP and clinical variables. CgA measurement in the plasma of elderly patients with symptoms of heart failure can identify those at increased risk of short- and long-term mortality.

Place, publisher, year, edition, pages
Bioscientifica, 2014. Vol. 3, no 1, 47-56 p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-108569DOI: 10.1530/EC-14-0017ISI: 000209773800009PubMedID: 24532383OAI: oai:DiVA.org:liu-108569DiVA: diva2:731007
Available from: 2014-06-30 Created: 2014-06-30 Last updated: 2017-12-05Bibliographically approved

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Alehagen, Urban

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Division of Cardiovascular MedicineFaculty of Health SciencesDepartment of Cardiology in Linköping
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