The value of biomarkers in predicting the course of heart failure of ischemic genesis in patients with atrial fibrillation and diabetes mellitus

Abstract

Aim To study the prognostic value of biomarkers in patients with heart failure of ischemic origin with concomitant atrial fibrillation and diabetes mellitus.

Material and methods 398 patients with heart failure (HF) on the background of post-infarction cardiosclerosis (198 women and 200 men) were included in the study. Patients were divided into 3 groups depending on the HF phenotype: Group I – 167 (42.0%) patients who had reduced LV EF (≤ 40%); II group – 133 (33.4%) patients with moderately reduced LV EF (41-49%); Group III – 98 (24.6%) patients with preserved LV EF (≥ 50%).

Results In HF patients with reduced LVEF, compared to patients who had moderately reduced and preserved FE, IV FK according to NYHA and AF are more often diagnosed 70.1%, against 53.4% and 38.8%; 2 = 25.57, p = 0.0001); higher one-year mortality (12.0%, against 1.5% and 4.1%), approximately the same frequency of RH; higher levels of NT-proBNP (by 16.2%, at p = 0.015) and ST-2 (43.0 [38.3 – 47.3] ng/ml, against 41.0 [35.8 – 44.6 ] ng/ml and 41.2 [37.0 – 44.6] ng/ml, with p = 0.004). The NT-proBNP / BNP ratio > 10.17 AU had a higher prognostic value compared to NT-proBNP for PG.

Conclusions In patients with heart failure of ischemic genesis with concomitant atrial fibrillation and diabetes mellitus, the NT-proBNP /ST-2 ratio >17.12 AU has the greatest prognostic value (Se=85.1%; Sp=80.0%). The frequency of RH in this group reaches 97.6% during the year.