Plasma chromogranin A is a marker of death in elderly patients presenting with symptoms of heart failure
2014 (English)In: Endocrine Connections, ISSN 2049-3614, Vol. 3, no 1, 47-56 p.Article in journal (Refereed) Published
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
2014. Vol. 3, no 1, 47-56 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-108569DOI: 10.1530/EC-14-0017PubMedID: 24532383OAI: oai:DiVA.org:liu-108569DiVA: diva2:731007