TY - JOUR
T1 - Urinary albumin excretion in heart failure with preserved ejection fraction
T2 - An interim analysis of the CHART 2 study
AU - Miura, Masanobu
AU - Shiba, Nobuyuki
AU - Nochioka, Kotaro
AU - Takada, Tsuyoshi
AU - Takahashi, Jun
AU - Kohno, Haruka
AU - Shimokawa, Hiroaki
PY - 2012/4
Y1 - 2012/4
N2 - Aims: Heart failure with preserved ejection fraction (HFpEF) is characterized by multiple co-morbidities, including chronic kidney disease that is one of the prognostic risks for these patients. This study was performed to evaluate the value of determination of albuminuria using a urine dipstick test (UDT), combined with estimated glomerular filtration rate (eGFR), for predicition of mortality in HFpEF. Methods and results: We enrolled 2465 consecutive patients with overt HF with EF <50 in our Chronic Heart Failure Analysis and Registry in the Tohoku District 2 (CHART-2) study (NCT00418041). We defined trace or more UDT as positive. We divided the patients into the following four groups based on eGFR and UDT; group 1 (G1) (eGFR <60, negative UDT), G2 (eGFR <60, positive UDT), G3 (eGFR <60, negative UDT), and G4 (eGFR <60, positive UDT). In total, 29.5 of the HFpEF patients had a positive UDT. HFpEF patients with a positive UDT were characterized by higher brain natriuretic peptide levels and frequent histories of hypertension or diabetes. During a mean follow-up of 2.5 years, HFpEF patients with a positive UDT showed higher mortality in each stratum of eGFR levels. A multivariable adjusted Cox model showed that when compared with G1 (reference), the hazard ratio of all-cause death for G2, G3, and G4 was 2.44 (95 confidence interval 1.474.05, P0.001), 1.43 (0.922.23, P0.12), and 2.71 (1.724.27, P<0.001), respectively. Furthermore, the prognostic value of a positive UDT was robust for both cardiovascular and non-cardiovascular deaths. Conclusions: These results indicate that measurement of albuminuria in addition to eGFR is useful for appropriate risk stratification in HFpEF patients. Published on behalf of the European Society of Cardiology. All rights reserved.
AB - Aims: Heart failure with preserved ejection fraction (HFpEF) is characterized by multiple co-morbidities, including chronic kidney disease that is one of the prognostic risks for these patients. This study was performed to evaluate the value of determination of albuminuria using a urine dipstick test (UDT), combined with estimated glomerular filtration rate (eGFR), for predicition of mortality in HFpEF. Methods and results: We enrolled 2465 consecutive patients with overt HF with EF <50 in our Chronic Heart Failure Analysis and Registry in the Tohoku District 2 (CHART-2) study (NCT00418041). We defined trace or more UDT as positive. We divided the patients into the following four groups based on eGFR and UDT; group 1 (G1) (eGFR <60, negative UDT), G2 (eGFR <60, positive UDT), G3 (eGFR <60, negative UDT), and G4 (eGFR <60, positive UDT). In total, 29.5 of the HFpEF patients had a positive UDT. HFpEF patients with a positive UDT were characterized by higher brain natriuretic peptide levels and frequent histories of hypertension or diabetes. During a mean follow-up of 2.5 years, HFpEF patients with a positive UDT showed higher mortality in each stratum of eGFR levels. A multivariable adjusted Cox model showed that when compared with G1 (reference), the hazard ratio of all-cause death for G2, G3, and G4 was 2.44 (95 confidence interval 1.474.05, P0.001), 1.43 (0.922.23, P0.12), and 2.71 (1.724.27, P<0.001), respectively. Furthermore, the prognostic value of a positive UDT was robust for both cardiovascular and non-cardiovascular deaths. Conclusions: These results indicate that measurement of albuminuria in addition to eGFR is useful for appropriate risk stratification in HFpEF patients. Published on behalf of the European Society of Cardiology. All rights reserved.
KW - Albuminuria
KW - Estimated glomerular filtration rate
KW - Heart failure with preserved ejection fraction
KW - Urine dipstick test
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U2 - 10.1093/eurjhf/hfs001
DO - 10.1093/eurjhf/hfs001
M3 - Article
C2 - 22298637
AN - SCOPUS:84859130624
VL - 14
SP - 367
EP - 376
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 4
ER -