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SHR Neuro Krebs Kardio Lipid

Kleber, ME; Koller, L; Goliasch, G; Sulzgruber, P; Scharnagl, H; Silbernagel, G; Grammer, TB; Delgado, G; Tomaschitz, A; Pilz, S; März, W; Niessner, A.
Von Willebrand factor improves risk prediction in addition to N-terminal pro-B-type natriuretic peptide in patients referred to coronary angiography and signs and symptoms of heart failure and preserved ejection fraction.
Circ Heart Fail. 2015; 8(1):25-32 [OPEN ACCESS]
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Autor/innen der Med Uni Graz:
Maerz Winfried
Pilz Stefan
Scharnagl Hubert
Silbernagel Günther
Tomaschitz Andreas
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Abstract:
Heart failure with preserved ejection fraction (HFpEF) represents a growing health burden associated with substantial mortality and morbidity. Consequently, risk prediction is of highest importance. Endothelial dysfunction has been recently shown to play an important role in the complex pathophysiology of HFpEF. We therefore aimed to assess von Willebrand factor (vWF), a marker of endothelial damage, as potential biomarker for risk assessment in patients with HFpEF. Concentrations of vWF were assessed in 457 patients with HFpEF enrolled as part of the LUdwigshafen Risk and Cardiovascular Health (LURIC) study. All-cause mortality was observed in 40% of patients during a median follow-up time of 9.7 years. vWF significantly predicted mortality with a hazard ratio (HR) per increase of 1 SD of 1.45 (95% confidence interval, 1.26-1.68; P<0.001) and remained a significant predictor after adjustment for age, sex, body mass index, N-terminal pro-B-type natriuretic peptide (NT-proBNP), renal function, and frequent HFpEF-related comorbidities (adjusted HR per 1 SD, 1.22; 95% confidence interval, 1.05-1.42; P=0.001). Most notably, vWF showed additional prognostic value beyond that achievable with NT-proBNP indicated by improvements in C-Statistic (vWF×NT-proBNP: 0.65 versus NT-proBNP: 0.63; P for comparison, 0.004) and category-free net reclassification index (37.6%; P<0.001). vWF is an independent predictor of long-term outcome in patients with HFpEF, which is in line with endothelial dysfunction as potential mediator in the pathophysiology of HFpEF. In particular, combined assessment of vWF and NT-proBNP improved risk prediction in this vulnerable group of patients. © 2014 American Heart Association, Inc.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Aged - epidemiology
Cause of Death - trends
Confidence Intervals -
Coronary Angiography - methods
Female -
Follow-Up Studies -
Heart Failure - blood Heart Failure - epidemiology Heart Failure - radiography
Humans -
Male -
Middle Aged -
Morbidity - trends
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Retrospective Studies -
Risk Assessment - methods
Stroke Volume - physiology
Survival Rate - trends
von Willebrand Factor - metabolism

Find related publications in this database (Keywords)
diastolic heart failure
prognosis
von Willebrand factor
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