The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure

Yin Yuan,1 Feng Huang,1– 4 Chaochao Deng,3 Pengli Zhu1,2 1The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People’s Republic of Chi...

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Autores principales:	Yuan Y, Huang F, Deng C, Zhu P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	ghrelin acute heart failure prognosis elderly Geriatrics RC952-954.6
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spelling	oai:doaj.org-article:d14fc937cd324c73b5c842de6e92affe2021-12-02T10:15:16ZThe Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure1178-1998https://doaj.org/article/d14fc937cd324c73b5c842de6e92affe2020-08-01T00:00:00Zhttps://www.dovepress.com/the-additional-prognostic-value-of-ghrelin-for-mortality-and-readmissi-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yin Yuan,1 Feng Huang,1– 4 Chaochao Deng,3 Pengli Zhu1,2 1The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People’s Republic of China; 3Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, Fujian, People’s Republic of China; 4Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People’s Republic of ChinaCorrespondence: Feng Huang; Pengli Zhu Email wmhf0327@126.com; zpl7755@hotmail.comPurpose: To evaluate the prognostic value of ghrelin, a growth hormone-releasing peptide, for mortality and readmission in elderly patients with acute heart failure (AHF).Patients and Methods: We measured plasma ghrelin and pro B-type natriuretic peptide (NT-proBNP) levels upon emergency admission in 241 prospectively recruited elderly AHF patients (61.0% men). The outcomes were all-cause mortality and/or readmission due to heart failure (HF). Multivariate Cox proportional hazards regression analyses were used to evaluate the prognostic value of ghrelin. Discrimination, calibration, and reclassification indices were compared between models, with or without ghrelin.Results: During 1.2 years of follow-up, we observed 90 events (57 deaths and 33 readmissions due to HF). Plasma ghrelin levels were significantly elevated in elderly AHF patients, when compared to healthy control subjects (P < 0.001). Patients with events had significantly higher baseline ghrelin levels, when compared to those without (P < 0.001). Ghrelin levels were positively correlated with NT-proBNP levels and HF severity, whereas they were negatively correlated with nutritional status (all P < 0.05). Log transformed ghrelin levels were independently associated with AHF events (hazard ratio = 2.64, 95% confidence interval = 1.11– 6.25, P = 0.028). The incorporation of ghrelin into the reference model, or reference with the NT-proBNP model, both improved C-statistics (from 0.742– 0.780 and 0.836– 0.857; P = 0.074 and 0.044, respectively), resulting in an improvement in net reclassification index (14.42% and 10.45%, P = 0.020 and 0.025, respectively), and integrated discrimination index (5.64% and 3.60%, both P < 0.001). Patients who displayed the above NT-proBNP and ghrelin median levels had a markedly higher risk of AHF adverse events (P < 0.001).Conclusion: Plasma ghrelin is an independent predictor of adverse events in elderly AHF patients. Ghrelin may provide additional value to clinical parameters or NT-proBNP for prognostic risk stratification in AHF.Keywords: ghrelin, acute heart failure, prognosis, elderlyYuan YHuang FDeng CZhu PDove Medical Pressarticleghrelinacute heart failureprognosiselderlyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 1353-1363 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	ghrelin acute heart failure prognosis elderly Geriatrics RC952-954.6
spellingShingle	ghrelin acute heart failure prognosis elderly Geriatrics RC952-954.6 Yuan Y Huang F Deng C Zhu P The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure
description	Yin Yuan,1 Feng Huang,1– 4 Chaochao Deng,3 Pengli Zhu1,2 1The Shengli Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People’s Republic of China; 3Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, Fujian, People’s Republic of China; 4Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People’s Republic of ChinaCorrespondence: Feng Huang; Pengli Zhu Email wmhf0327@126.com; zpl7755@hotmail.comPurpose: To evaluate the prognostic value of ghrelin, a growth hormone-releasing peptide, for mortality and readmission in elderly patients with acute heart failure (AHF).Patients and Methods: We measured plasma ghrelin and pro B-type natriuretic peptide (NT-proBNP) levels upon emergency admission in 241 prospectively recruited elderly AHF patients (61.0% men). The outcomes were all-cause mortality and/or readmission due to heart failure (HF). Multivariate Cox proportional hazards regression analyses were used to evaluate the prognostic value of ghrelin. Discrimination, calibration, and reclassification indices were compared between models, with or without ghrelin.Results: During 1.2 years of follow-up, we observed 90 events (57 deaths and 33 readmissions due to HF). Plasma ghrelin levels were significantly elevated in elderly AHF patients, when compared to healthy control subjects (P < 0.001). Patients with events had significantly higher baseline ghrelin levels, when compared to those without (P < 0.001). Ghrelin levels were positively correlated with NT-proBNP levels and HF severity, whereas they were negatively correlated with nutritional status (all P < 0.05). Log transformed ghrelin levels were independently associated with AHF events (hazard ratio = 2.64, 95% confidence interval = 1.11– 6.25, P = 0.028). The incorporation of ghrelin into the reference model, or reference with the NT-proBNP model, both improved C-statistics (from 0.742– 0.780 and 0.836– 0.857; P = 0.074 and 0.044, respectively), resulting in an improvement in net reclassification index (14.42% and 10.45%, P = 0.020 and 0.025, respectively), and integrated discrimination index (5.64% and 3.60%, both P < 0.001). Patients who displayed the above NT-proBNP and ghrelin median levels had a markedly higher risk of AHF adverse events (P < 0.001).Conclusion: Plasma ghrelin is an independent predictor of adverse events in elderly AHF patients. Ghrelin may provide additional value to clinical parameters or NT-proBNP for prognostic risk stratification in AHF.Keywords: ghrelin, acute heart failure, prognosis, elderly
format	article
author	Yuan Y Huang F Deng C Zhu P
author_facet	Yuan Y Huang F Deng C Zhu P
author_sort	Yuan Y
title	The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure
title_short	The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure
title_full	The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure
title_fullStr	The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure
title_full_unstemmed	The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure
title_sort	additional prognostic value of ghrelin for mortality and readmission in elderly patients with acute heart failure
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/d14fc937cd324c73b5c842de6e92affe
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The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure

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