1) Department of Emergency, Suez Canal University, Ismailia, Egypt.
2) Department of Cardiology, Suez Canal University, Ismailia, Egypt.
Disclosure: The author has declared no conflicts of interest.
Received: 27.07.16 Accepted: 03.09.16
Background : Heart failure (HF) has become one of the most important problems in health care in the western world. There are over 26 million people who suffer from heart failure in the world. Half of all patients diagnosed with heart failure die within four years. It is very important to predict if a patient will die soon so that an effective prevention can be employed. However, characteristics and outcome of HF patients are not well investigated in developing countries like Egypt.
Patients & Methods: was to assess the short term predictive value of simple biomarkers (such as d-dimer, CRP & ESR) regarding cardiovascular mortality and major cardiovascular events in patients with severe heart failure. This is cross sectional study, the study included 141 patients.
Results: according to ESR, CRP, d-dimer as predictors of hospital admission within one month follow-up:45.9 % of the patients had moderately elevated ESR, 72.1% of the patients had high CRP and 13.1 % of the patients had positive D-dimer. According to ESR, CRP, D-dimer as predictors of mortality within one month follow up: 83.3% of the patients had moderately elevated ESR within first hour, 83.3% of the patients had high CRP and 33.3% of the patients had positive D-dimer.
Conclusion: ESR may be a good predictor of mortality within one month follow up, while CRP, D-dimer are not.
Keywords: Heart failure mortality, ESR, CRP, D-dimer, Biomarkers
1. López-Sendón J Medicographia Heart failure today: Medicographia, Q Themat J Clin Ther Res A Servier Publ. 2011; 33.
Khaled Moursy Salama et al./ International Journal of Surgery and Medicine (2017) 3(1):37-41
2. Wael El-Naggar, Sameh Hozayen, Nabil Farag, Sameh Sabet, Ramy Raymond MER, and AH. Characteristics and outcome of acute heart failure patients in Egypt. Characteristics and Outcome of Acute Heart Failure Patients in Egypt. Hear Mirror J. 2009.
3. Lloyd-Jones DM, Evans JC, Levy D. Hypertension in adults across the age spectrum: Current outcomes and control in the community.JAMA 2005; 294:466-72.
4. Nancy Albert, Kathleen Trochelman, Jianbo Li, and Songhua Lin. Signs and symptoms of heart failure: are
you asking the right questions?.2010;19:1-11.
5. Clement E. L.Makule. Causes of readmission for heart failure at Muhmbilnational hospital. ACT. 2002;1-129.
6. Bin Tong & Chris Stevenson. Comorbidity of cardiovascular disease, diabetes and chronic kidney disease in Australia.
Australian Institute of Health and Welfare, Canberra, AIHW cat. no. CVD 37.2007;28:1-72.
7. Mueller C, Frana B, Rodriquez D, Laule-Kilian K, Perruchoud AP. Emergency diagnosis of congestive heart failure: impact of signs and symptoms. Can J Cardiol. 2005;21:921- 924.
8. Fonarow GC, Heywood JT, Heidenreich PA, Lopatin M, Yancy CW; ADHERE Scientific Advisory Committee and Investigators.
Temporal trends in clinical characteristics, treatments, and outcomes for heart failure hospitalizations, 2002 to 2004: findings from Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2007;153:1021- 1028.
9. Fonarow GC, Abraham WT, Albert NM, et al.; for the OPTIMIZE-HF Investigators and Hospitals. Influence of a performance-improvement initiative on quality of care for patients hospitalized with heart failure. Results of the Organized Program to Initiate Lifesaving Treatment in Hospitalized
Patients with Heart Failure (OPTIMIZE-HF). Arch Intern Med. 2007;167:1493-1502.
10. J Mant, J Doust, A Roalfe, P Barton, MR Cowie, P Glasziou, D Mant, RJ McManus, R Holder, J Deeks, K Fletcher, M Qume, S Sohanpal, S Sanders and FDR Hobbs. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modeling of implications
of different diagnostic strategies in primary care. Health Technology Assessment 2009; 13:1-248.
11. Lars G. Olsson, Karl Swedberg, Anique Ducharme, Christopher B. Granger, Eric L. Michelson, John J. V. McMurray, Margareta Puu, Salim Yusuf& Marc A. Pfeffer, on behalf of the CHARM Investigators. Atrial fibrillation and risk of clinical events in chronic heart Failure with and without left
ventricular systolic dysfunction. 2006; 47:1997-2004.
12. Bonnie Ky, Benjamin French, Wayne C. Levy, Nancy K. Sweitzer, James C. Fang, Alan H.B. Wu, Lee R. Goldberg, Mariell Jessup and Thomas P. Cappola. Multiple biomarkers for risk prediction in chronic heart failure. Circ Heart Fail 2012;5;183-190
13. Eric S. Williams, Sanjiv J. Shah, Sadia Ali, Bee Ya Na, Nelson B. Schiller and Mary A. Whooley. C-reactive protein, diastolic dysfunction, and risk of heart failure in patients with coronary disease: Heart and Soul Study. 1.Eur J Heart Fail 2008; 10: 63-69.
14. G. Erikssen, K. Liestøl, J. V. Bjørnholt, H. Stormorken, E. Thaulow and J. Erikssen. Erythrocyte sedimentation rate: a possible marker of atherosclerosis and a strong predictor of coronary heart disease mortality. European Heart Journal. 2000; 21: 1614–1620.
15. Sharma R, Rauchhaus M, Ponikowski PP, et al. The relationship of the erythrocyte sedimentation rate to inflammatory
cytokines and survival in patients with chronic heart failure treated with angiotensin-converting enzyme inhibitors. J
Am Coll Cardiol. 2000; 36:523–8.
16. Francisco J Ruiz-Ruiz, Beatriz Sierra Bergua, Álvaro Flamarique Pascual, Juan Perez-Calvo. Prognostic value of erythrocyte sedimentation rate in patients with decompensated heart failure. Journal of the New Zealand Medical Association 2004; 117:1207.
17. R. Marcucci, A. M. Gori, F. Giannotti, M. BaldiI, V. Verdiani, S. Del Pace, C. Nozzoli and R. Abbate. Markers of hypercoagulability
and inflammation predict mortality in patients with heart failure. J Thromb Haemost 2006; 4:1017–22.
18. Alonso-Martinez JL, Lorente-Diez B, Echegaray-Agara M, Olaz-Preciado F, Urbieta-Echezarreta M, GonzalezArencibia
C. C-reactive protein as a predictor of improvement and readmission in heart failure. Eur J Heart Fail 2002; 4: 331–6.
19. Alehagen U, Dahlstrom U, and Lindahl TL: Elevated D-dimer level is an independent risk factor for cardiovascular
death in out-patients with symptoms compatible with heart failure. Thromb Haemost, 2004; 92: 1250-8.
20. Dzudie A., Milo O., Edwards C., Cotter G., Davison BA., Damasceno A., Mayosi BM., Mondo C., Ogah O., Ojji D.,
Sani MU., Sliwa K. Prognostic significance of ECG abnormalities for mortality risk in acute heart failure: insight from
the Sub-Saharan Africa Survey of Heart Failure (THESUSHF). J Card Fail. 2014; 20:45-52.
21. Dawson B and Trapp RG. Basic& clinical biostatistics. 2004, Lange Medical Books/McGraw-Hill, Medical Pub. Division:
New York. 2004;4:1-416.
How to Cite this ArticleSalama, K. et al., 2017. PREDICTIVE VALUE OF SIMPLE BIOMARKERS OF MORTALITY IN PATIENTS WITH SEVERE HEART FAILURE IN EMERGENCY DEPARTMENT IN SUEZ CANAL UNIVERSITY HOSPITAL IN ISMAILIA. International Journal of Surgery and Medicine, 3(1), p.1. Available at: http://dx.doi.org/10.5455/ijsm.severe-heart-failure-predictive-biomarkers.
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