Amino Acid-Based Metabolic Panel Provides Robust Prognostic Value Additive to B-Natriuretic Peptide and Traditional Risk Factors in Heart Failure

Table 4

Cox univariate and multivariable analysis for HF-related rehospitalization and death (initiation cohort).

	Univariate		Multivariable
Item	Hazard ratio (95% CI)	value	Hazard ratio (95% CI)	value
HOP score	1.072 (1.044~1.100)	<0.001	1.057 (1.024~1.091)	0.001
Log (BNP) × 10^−1	1.078 (1.045~1.112)	<0.001	1.028 (0.995~1.063)	0.102
Age (years)	1.033 (1.020~1.046)	<0.001	1.029 (1.015~1.043)	<0.001
Sex	0.651 (0.478~0.886)	0.006	0.747 (0.519~1.075)	0.116
LVEF (%)	0.990 (0.980 ~1.000)	0.05	0.989 (0.977~1.001)	0.072
NYHA functional class ≥III	4.196 (1.720~10.233)	0.002	1.455 (0.565~3.748)	0.437
Stage D	1.839 (1.416~2.388)	<0.001	1.417 (1.021~1.088)	0.024
Systolic blood pressure (mmHg)	0.996 (0.988~1.005)	0.402
Diabetes mellitus	1.685 (1.241~2.288)	0.001	1.360 (0.972~1.902)	0.073
Chronic kidney disease	2.058 (1.503~2.818)	<0.001	1.516 (1.078~2.132)	0.017
Hypertension	1.458 (1.035~2.054)	0.031	1.039 (0.712~1.516)	0.843
Atrial fibrillation	1.274 (0.926~1.751)	0.136
Body mass index (kg/m^2)	0.971 (0.935~1.008)	0.119
Serum sodium (mEq/L)	0.976 (0.936~1.018)	0.189
Hemoglobin (g/dL)	0.873 (0.814~0.935)	<0.001	0.970 (0.887~1.059)	0.495
Albumin (g/dL)	0.531 (0.409~0.690)	<0.001	0.755 (0.546~1.044)	0.089

BNP: B-type natriuretic peptide; chronic kidney disease, estimated glomerular filtration rate ; HOP: histidine, ornithine and phenylalanine; LVEF: left ventricular ejection fraction; NYHA: New York Heart Association.