Journal of Yeungnam Medical Science

영남대 의대 학술지 편집위원회 (Yeungnam University College of Medicine, Yeungnam University Institute Medical Science)
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Prognostic impact of chromogranin A in patients with acute heart failure

  • Kim, Hong Nyun (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Yang, Dong Heon (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Park, Bo Eun (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Park, Yoon Jung (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Kim, Hyeon Jeong (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Jang, Se Yong (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Bae, Myung Hwan (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Lee, Jang Hoon (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Park, Hun Sik (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Cho, Yongkeun (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Chae, Shung Chull (Department of Internal Medicine, Kyungpook National University Hospital)
  • 투고 : 2020.11.17
  • 심사 : 2021.06.02
  • 발행 : 2021.10.31
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초록

Background: Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods: We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results: In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion: The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

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과제정보

This research was supported by the Kyungpook National University Research Fund (2020).

참고문헌

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