Serum beta2-microglobulin concentration as a novel marker to distinguish levels of risk in acute heart failure patients
Summary Background Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults. However, the prognostic role of beta2-microglobulin in heart failure has not been elucidated. Methods We prospectively evaluate...
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| Published in | Journal of cardiology Vol. 55; no. 1; pp. 99 - 107 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Elsevier Ltd
01.01.2010
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| Abstract | Summary Background Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults. However, the prognostic role of beta2-microglobulin in heart failure has not been elucidated. Methods We prospectively evaluated serum beta2-microglobulin and creatinine concentrations, creatinine-based renal parameters (estimated glomerular filtration rate and creatinine clearance), and echocardiographic data in 131 patients with acute heart failure and creatinine concentrations ≤3.0 mg/dL admitted to our hospitals. Results During 2.3 ± 1.3 years, 42 patients died of cardiovascular causes and 12 died of noncardiac causes. Cardiovascular events were observed in 63 patients: 53 were readmitted due to worsening heart failure, 5 readmitted for cerebral embolism, and 5 died from sudden cardiac death. According to multivariate stepwise Cox proportional hazard analysis, higher baseline serum beta2-microglobulin concentrations ( X2 = 16, p < 0.0001), previous congestive heart failure ( X2 = 11, p < 0.001), presence of chronic obstructive pulmonary disease ( X2 = 8, p < 0.01), and lower diastolic blood pressure ( X2 = 6, p < 0.05) were independent predictors of increased cardiovascular events. Also, higher baseline serum beta2-microglobulin ( X2 = 20, p < 0.0001), lower systolic blood pressure ( X2 = 11, p < 0.001), higher relative left ventricular wall thickness ( X2 = 6, p < 0.05), and lower body mass index ( X2 = 5, p < 0.05) were independent predictors of increased cardiac mortality. The adjusted hazard ratio for cardiovascular events increased with baseline serum beta2-microglobulin above 2.1 mg/L: 2.9 with beta2-microglobulin of 2.2–2.6 mg/L (95%CI 1.2–6.9, p < 0.05), 2.9 with beta2-microglobulin of 2.7–3.9 mg/L (95%CI 1.2–7.2, p < 0.05), and 4.7 with beta2-microglobulin of ≥4.0 mg/L (95%CI 2.0–11, p < 0.001). Conclusions Higher baseline serum beta2-microglobulin concentration could be a promising risk marker in acute heart failure patients with creatinine ≤3.0 mg/dL. |
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| AbstractList | Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults. However, the prognostic role of beta2-microglobulin in heart failure has not been elucidated.
We prospectively evaluated serum beta2-microglobulin and creatinine concentrations, creatinine-based renal parameters (estimated glomerular filtration rate and creatinine clearance), and echocardiographic data in 131 patients with acute heart failure and creatinine concentrations ≤3.0
mg/dL admitted to our hospitals.
During 2.3
±
1.3 years, 42 patients died of cardiovascular causes and 12 died of noncardiac causes. Cardiovascular events were observed in 63 patients: 53 were readmitted due to worsening heart failure, 5 readmitted for cerebral embolism, and 5 died from sudden cardiac death. According to multivariate stepwise Cox proportional hazard analysis, higher baseline serum beta2-microglobulin concentrations (
X
2
=
16,
p
<
0.0001), previous congestive heart failure (
X
2
=
11,
p
<
0.001), presence of chronic obstructive pulmonary disease (
X
2
=
8,
p
<
0.01), and lower diastolic blood pressure (
X
2
=
6,
p
<
0.05) were independent predictors of increased cardiovascular events. Also, higher baseline serum beta2-microglobulin (
X
2
=
20,
p
<
0.0001), lower systolic blood pressure (
X
2
=
11,
p
<
0.001), higher relative left ventricular wall thickness (
X
2
=
6,
p
<
0.05), and lower body mass index (
X
2
=
5,
p
<
0.05) were independent predictors of increased cardiac mortality. The adjusted hazard ratio for cardiovascular events increased with baseline serum beta2-microglobulin above 2.1
mg/L: 2.9 with beta2-microglobulin of 2.2–2.6
mg/L (95%CI 1.2–6.9,
p
<
0.05), 2.9 with beta2-microglobulin of 2.7–3.9
mg/L (95%CI 1.2–7.2,
p
<
0.05), and 4.7 with beta2-microglobulin of ≥4.0
mg/L (95%CI 2.0–11,
p
<
0.001).
Higher baseline serum beta2-microglobulin concentration could be a promising risk marker in acute heart failure patients with creatinine ≤3.0
mg/dL. Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults. However, the prognostic role of beta2-microglobulin in heart failure has not been elucidated. We prospectively evaluated serum beta2-microglobulin and creatinine concentrations, creatinine-based renal parameters (estimated glomerular filtration rate and creatinine clearance), and echocardiographic data in 131 patients with acute heart failure and creatinine concentrations < or =3.0mg/dL admitted to our hospitals. During 2.3+/-1.3 years, 42 patients died of cardiovascular causes and 12 died of noncardiac causes. Cardiovascular events were observed in 63 patients: 53 were readmitted due to worsening heart failure, 5 readmitted for cerebral embolism, and 5 died from sudden cardiac death. According to multivariate stepwise Cox proportional hazard analysis, higher baseline serum beta2-microglobulin concentrations (X(2)=16, p<0.0001), previous congestive heart failure (X(2)=11, p<0.001), presence of chronic obstructive pulmonary disease (X(2)=8, p<0.01), and lower diastolic blood pressure (X(2)=6, p<0.05) were independent predictors of increased cardiovascular events. Also, higher baseline serum beta2-microglobulin (X(2)=20, p<0.0001), lower systolic blood pressure (X(2)=11, p<0.001), higher relative left ventricular wall thickness (X(2)=6, p<0.05), and lower body mass index (X(2)=5, p<0.05) were independent predictors of increased cardiac mortality. The adjusted hazard ratio for cardiovascular events increased with baseline serum beta2-microglobulin above 2.1 mg/L: 2.9 with beta2-microglobulin of 2.2-2.6 mg/L (95%CI 1.2-6.9, p<0.05), 2.9 with beta2-microglobulin of 2.7-3.9 mg/L (95%CI 1.2-7.2, p<0.05), and 4.7 with beta2-microglobulin of > or =4.0 mg/L (95%CI 2.0-11, p<0.001). Higher baseline serum beta2-microglobulin concentration could be a promising risk marker in acute heart failure patients with creatinine < or =3.0 mg/dL. Summary Background Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults. However, the prognostic role of beta2-microglobulin in heart failure has not been elucidated. Methods We prospectively evaluated serum beta2-microglobulin and creatinine concentrations, creatinine-based renal parameters (estimated glomerular filtration rate and creatinine clearance), and echocardiographic data in 131 patients with acute heart failure and creatinine concentrations ≤3.0 mg/dL admitted to our hospitals. Results During 2.3 ± 1.3 years, 42 patients died of cardiovascular causes and 12 died of noncardiac causes. Cardiovascular events were observed in 63 patients: 53 were readmitted due to worsening heart failure, 5 readmitted for cerebral embolism, and 5 died from sudden cardiac death. According to multivariate stepwise Cox proportional hazard analysis, higher baseline serum beta2-microglobulin concentrations ( X2 = 16, p < 0.0001), previous congestive heart failure ( X2 = 11, p < 0.001), presence of chronic obstructive pulmonary disease ( X2 = 8, p < 0.01), and lower diastolic blood pressure ( X2 = 6, p < 0.05) were independent predictors of increased cardiovascular events. Also, higher baseline serum beta2-microglobulin ( X2 = 20, p < 0.0001), lower systolic blood pressure ( X2 = 11, p < 0.001), higher relative left ventricular wall thickness ( X2 = 6, p < 0.05), and lower body mass index ( X2 = 5, p < 0.05) were independent predictors of increased cardiac mortality. The adjusted hazard ratio for cardiovascular events increased with baseline serum beta2-microglobulin above 2.1 mg/L: 2.9 with beta2-microglobulin of 2.2–2.6 mg/L (95%CI 1.2–6.9, p < 0.05), 2.9 with beta2-microglobulin of 2.7–3.9 mg/L (95%CI 1.2–7.2, p < 0.05), and 4.7 with beta2-microglobulin of ≥4.0 mg/L (95%CI 2.0–11, p < 0.001). Conclusions Higher baseline serum beta2-microglobulin concentration could be a promising risk marker in acute heart failure patients with creatinine ≤3.0 mg/dL. BACKGROUNDRecently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults. However, the prognostic role of beta2-microglobulin in heart failure has not been elucidated.METHODSWe prospectively evaluated serum beta2-microglobulin and creatinine concentrations, creatinine-based renal parameters (estimated glomerular filtration rate and creatinine clearance), and echocardiographic data in 131 patients with acute heart failure and creatinine concentrations < or =3.0mg/dL admitted to our hospitals.RESULTSDuring 2.3+/-1.3 years, 42 patients died of cardiovascular causes and 12 died of noncardiac causes. Cardiovascular events were observed in 63 patients: 53 were readmitted due to worsening heart failure, 5 readmitted for cerebral embolism, and 5 died from sudden cardiac death. According to multivariate stepwise Cox proportional hazard analysis, higher baseline serum beta2-microglobulin concentrations (X(2)=16, p<0.0001), previous congestive heart failure (X(2)=11, p<0.001), presence of chronic obstructive pulmonary disease (X(2)=8, p<0.01), and lower diastolic blood pressure (X(2)=6, p<0.05) were independent predictors of increased cardiovascular events. Also, higher baseline serum beta2-microglobulin (X(2)=20, p<0.0001), lower systolic blood pressure (X(2)=11, p<0.001), higher relative left ventricular wall thickness (X(2)=6, p<0.05), and lower body mass index (X(2)=5, p<0.05) were independent predictors of increased cardiac mortality. The adjusted hazard ratio for cardiovascular events increased with baseline serum beta2-microglobulin above 2.1 mg/L: 2.9 with beta2-microglobulin of 2.2-2.6 mg/L (95%CI 1.2-6.9, p<0.05), 2.9 with beta2-microglobulin of 2.7-3.9 mg/L (95%CI 1.2-7.2, p<0.05), and 4.7 with beta2-microglobulin of > or =4.0 mg/L (95%CI 2.0-11, p<0.001).CONCLUSIONSHigher baseline serum beta2-microglobulin concentration could be a promising risk marker in acute heart failure patients with creatinine < or =3.0 mg/dL. |
| Author | Yokoyama, Mitsuhiro, MD, FJCC Miyazaki, Toshiyuki, MD Tajiri, Eiichi, MD Shirotani, Tomohiko, MD Mori, Masuki, MD Kawashima, Seinosuke, MD Inatome, Tetsuya, MD Kawai, Keisuke, MD Hirata, Ken-ichi, MD Yamabe, Hiroshi, MD Kitazaki, Kazuhisa, MD |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20122555$$D View this record in MEDLINE/PubMed |
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| Snippet | Summary Background Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in... Recently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older adults.... BACKGROUNDRecently, serum beta2-microglobulin, an endogenous marker for renal function, has been shown to be an independent predictor of mortality in older... |
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| SubjectTerms | Aged beta 2-Microglobulin - blood Biomarkers - blood Blood Pressure Body Mass Index Cardiovascular Creatinine - blood Creatinine - metabolism Echocardiography Female Glomerular Filtration Rate Heart Failure - blood Heart Failure - mortality Humans Male Mortality Nedocromil Outcome Predictor Prognosis Pulmonary Disease, Chronic Obstructive - complications Recurrence |
| Title | Serum beta2-microglobulin concentration as a novel marker to distinguish levels of risk in acute heart failure patients |
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