Additive Value of Biomarkers and Echocardiography to Stratify the Risk of Death in Heart Failure Patients with Reduced Ejection Fraction
Table 3
Candidate predictors and mortality (univariable Cox model).
Predictor
Number of deaths
Rate per 100 persons per year (95% CI)
HR (95% CI)
value
TAPSE/PASP ratio
<0.36
11
9.9 (5.5–17.8)
1
<0.001
≥0.36
26
3.6 (2.4–5.2)
0.34 (0.28–0.41)
<0.001
Unavailable
13
2.9 (1.7–5.0)
0.26 (0.12–0.56)
0.001
Number of biomarkers over threshold (NPs and hsTnI)
0
13
2.3 (1.3–4.0)
1
<0.001^
1
22
4.3 (2.8–6.5)
1.86 (0.78–4.43)
0.162
2
15
7.3 (4.4–12.0)
3.01 (1.67–5.44)
<0.001
NPs
≤Threshold
15
2.2 (1.3–3.6)
1
0.006
>Threshold
35
5.9 (4.2–8.2)
2.70 (1.32–5.49)
hsTnI
≤0.027 pg/ml
33
3.4 (2.4–4.8)
1
<0.001
>0.027 pg/ml
17
5.2 (3.2–8.4)
1.42 (1.18–1.70)
EDT (msec)
≥140
35
3.7 (2.7–5.1)
1
0.593
<140
13
4.1 (2.4–7.1)
1.08 (0.81–1.44)
Age
≤66
17
2.4 (1.5–3.9)
1
0.032
>66
33
5.8 (4.0–7.9)
2.37 (1.08–5.21)
Gender
M
38
3.5 (2.6–4.8)
1
0.005
F
12
5.9 (3.3–10.4)
1.75 (1.19–2.56)
TAPSE: tricuspid annular plane systolic excursion; PASP: pulmonary artery systolic pressure; NPs: natriuretic peptides (brain natriuretic peptide (BNP), and N-terminal-proBNP (NT-proBNP)); NPs thresholds are 125 pg/ml for BNP and 1016 pg/ml for NT-proBNP; hsTnI: high sensitivity troponin I, threshold 0.027 pg/ml; EDT: mitral inflow E velocity deceleration time. ^Test for linearity of effect : there is a linear increase in risk of death with increasing number of positive biomarkers.
