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Aplica??o de escore de marcadores de baixo custo no prognóstico de pacientes com insuficiência cardíaca cr?nica

Keywords: biomarkers, heart failure, prognosis.

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Abstract:

purpose. to demonstrate that score based on low cost laboratory markers can determine prognosis of ambulatory patients with heart failure (hf). introduction. hf is a disease known for her evolving with high mortality. biomarkers are emerging as an important aid in the standard clinical evaluation of a variety of cardiovascular disorders, including hf. methods. this study consists on a prospective cohort of outpatients with hf, the markers selected were: sodium, high density lipoprotein (hdl), creatinine, creatinine clearance, uric acid and hemoglobin. one point for changes in each marker was given and defined as low risk: 0-2 points, moderate risk: 3-4 points, and high risk: 5-6 points. the primary outcome was death from cardiovascular causes and secondary deaths from cardiovascular causes associated with hospitalizations for cardiovascular causes. the statistical methods used were chi-square, student t test, cox regression and it was used the kaplan meier curve analysis of events. results. we studied 146 patients with mean age 58±13.04, 44 male patients (30.2%) and 102 female ones (69.8%). the primary outcomes were: 15 (10.2%) deaths and secondary: 54 (37%) compound events. the number of individuals according to the stage of risk: low: 68, intermediate: 63 and higher: 15. the rate of events in low, intermediate and high risk were eight (11.7%), 34 (54%) and 12 (80%), respectively. according to the risk stratification, the hazard ratio for low risk (hr=0.14, p=0.0001), moderate (hr=1.69, p=0.01) and high (hr=2.46, p=0.001). conclusion. the multi-markers score based on markers of low cost admits prognostic stratification of patients, allowing predicting deaths and hospital admissions, and also creating a therapeutic strategy for follow-up of patients according to risk stratification.

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