Incremental prognostic value of a novel metabolite-based biomarker score in congestive heart failure patients

Aims: The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite-based biomarkers that has shown to improve the diagnostic value of N terminal pro B type natriuretic peptide (NT-proBNP). However, little is known about its usefulness in predicting outcomes. In this study, we developed a risk score for 4-year cardiovascular death in elderly chronic heart failure (CHF) patients using the CLP. Methods and results: From the Cardiac Insufficiency Bisoprolol Study in Elderly trial, we included 280 patients with CHF aged \u3e65 years. A targeted metabolomic analysis of the CLP biomarkers was performed on baseline serum samples. Cox regression was used to determine the association of the biomarkers with the outcome after accounting for established risk factors. A risk score ranging from 0 to 4 was calculated by counting the number of biomarkers above the cut-offs, using Youden index. During the mean (standard deviation) follow-up period of 50 (8) months, 35 (18%) subjects met the primary endpoint of cardiovascular death. The area under the receiver operating curve for the model based on clinical variables was 0.84, the second model with NT-proBNP was 0.86, and the final model with the CLP was 0.90. The categorical net reclassification index was 0.25 using three risk categories: 0-60% (low), 60-85% (intermediate), and \u3e85% (high). The continuous net reclassification index was 0.772, and the integrated discrimination index was 0.104. Conclusions: In patients with CHF, incorporating a panel of three metabolite-based biomarkers into a risk score improved the prognostic utility of NT-proBNP by predicting long-term cardiovascular death more precisely. This novel approach holds promise to improve clinical risk assessment in CHF patients. Keywords: Biomarkers; Congestive heart failure; Metabolite profiling; Metabolomics; Prognosi

Performance of a cardiac lipid panel compared to four prognostic scores in chronic heart failure

The cardiac lipid panel (CLP) is a novel panel of metabolomic biomarkers that has previously shown to improve the diagnostic and prognostic value for CHF patients. Several prognostic scores have been developed for cardiovascular disease risk, but their use is limited to specific populations and precision is still inadequate. We compared a risk score using the CLP plus NT-proBNP to four commonly used risk scores: The Seattle Heart Failure Model (SHFM), Framingham risk score (FRS), Barcelona bio-HF (BCN Bio-HF) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score. We included 280 elderly CHF patients from the Cardiac Insufficiency Bisoprolol Study in Elderly trial. Cox Regression and hierarchical cluster analysis was performed. Integrated area under the curves (IAUC) was used as criterium for comparison. The mean (SD) follow-up period was 81 (33) months, and 95 (34%) subjects met the primary endpoint. The IAUC for FRS was 0.53, SHFM 0.61, BCN Bio-HF 0.72, MAGGIC 0.68, and CLP 0.78. Subjects were partitioned into three risk clusters: low, moderate, high with the CLP score showing the best ability to group patients into their respective risk cluster. A risk score composed of a novel panel of metabolite biomarkers plus NT-proBNP outperformed other common prognostic scores in predicting 10-year cardiovascular death in elderly ambulatory CHF patients. This approach could improve the clinical risk assessment of CHF patients

THE RELATIONSHIP BETWEEN THE ANTHROPOMETRIC MEASURES AND RESPIRATORY FUNCTIONS OF TOBACCO WORKERS

The aim of this research was to establish the relationship between some anthropometric measurements and peak expiratory flow rate of tobacco factory workers. Eighty permanent workers who had been employed for at least three years with no history of cardiovascular disease were involved with the study. The measured anthropometric data (chest width and depth, height and weight) were analyzed using SPSS (V 16.0) to develop predictive models for PEFR of tobacco factory workers. It was concluded that the developed models could determine the PEFR of workers in a tobacco manufacturing company

THE RELATIONSHIP BETWEEN THE ANTHROPOMETRIC MEASURES AND RESPIRATORY FUNCTIONS OF TOBACCO WORKERS

The aim of this research was to establish the relationship between some anthropometric measurements and peak expiratory flow rate of tobacco factory workers. Eighty permanent workers who had been employed for at least three years with no history of cardiovascular disease were involved with the study. The measured anthropometric data (chest width and depth, height and weight) were analyzed using SPSS (V 16.0) to develop predictive models for PEFR of tobacco factory workers. It was concluded that the developed models could determine the PEFR of workers in a tobacco manufacturing company

DEVELOPMENT OF VEHICLE EMISSION REDUCTION UNIT (VERU) FOR USE IN PETROL ENGINES

Emisije plinova iz vozila glavni su uzrok zagađenosti zraka u modernim gradovima. Sve veći broj osobnih automobila, posebno u zadnjem desetljeću, doveo je do složenih prometnih teškoća i ozbiljnog povećanja potrošnje goriva i emisija plinova. Cilj je razviti napravu koja će smanjiti štetne sastojke u ispušnim pliovima iz vozila prije njihova ispuštanja u atmosferu. VERU (Vehicle Emissions Reduction Unit = naprava za smanjenje emisija) je upotrebljavan za upijanje određenih količina ugljičnog dioksida, ugljičnog monoksida i ugljikovodika koji bi inače završili u atmosferi. VERU se sastoji od metalne cijevi i smjese načinjene od gline, soda vapna i vode, oblikovane u kuglice koje se zatim suše na suncu. Suhe kuglice namjeste se u cijev koja se pričvrsti na kraj ispušne cijevi vozila. Rezultati ispitivanja VERU naprave pokazuju smanjenje ugljičnog dioksida za 60 %, ugljičnog monoksida za 73 % i ugljikovodika za 80 %, dok je količina kisika veća 150 %. Stoga je zaključeno da bi VERU mogao smanjiti emisije plinova iz vozila i iz tog se razloga preporuča njegova uporaba.Vehicle emissions constitute the main source of atmospheric pollution in modern cities. The increasing number of passenger cars, especially during the last decade, has resulted in composite traffic problems with serious consequences on emissions and fuel consumption. The main focus is on the development of a unit to reduce the constituents of vehicle emissions before they get into the atmosphere. The Vehicle Emissions Reduction Unit (VERU) was used to absorb certain percentages of carbon dioxide (CO2), carbon monoxide (CO), and hydrocarbons (HC) which would have been emitted into the atmosphere. The VERU consists of a canister and specimen prepared by mixing clay with soda lime and water and rolled into balls which were then sun dried. The sun dried specimen were placed in the canister and applied at the tail end of exhaust pipes of vehicles. The results of the tests carried out using VERU showed that CO2 was reduced by 60%, CO by 73%, HC by 80%, while O2 was increased by 150%. It was concluded that the use of VERU could reduce vehicle emissions and is therefore recommended for use

DEVELOPMENT OF VEHICLE EMISSION REDUCTION UNIT (VERU) FOR USE IN PETROL ENGINES

Emisije plinova iz vozila glavni su uzrok zagađenosti zraka u modernim gradovima. Sve veći broj osobnih automobila, posebno u zadnjem desetljeću, doveo je do složenih prometnih teškoća i ozbiljnog povećanja potrošnje goriva i emisija plinova. Cilj je razviti napravu koja će smanjiti štetne sastojke u ispušnim pliovima iz vozila prije njihova ispuštanja u atmosferu. VERU (Vehicle Emissions Reduction Unit = naprava za smanjenje emisija) je upotrebljavan za upijanje određenih količina ugljičnog dioksida, ugljičnog monoksida i ugljikovodika koji bi inače završili u atmosferi. VERU se sastoji od metalne cijevi i smjese načinjene od gline, soda vapna i vode, oblikovane u kuglice koje se zatim suše na suncu. Suhe kuglice namjeste se u cijev koja se pričvrsti na kraj ispušne cijevi vozila. Rezultati ispitivanja VERU naprave pokazuju smanjenje ugljičnog dioksida za 60 %, ugljičnog monoksida za 73 % i ugljikovodika za 80 %, dok je količina kisika veća 150 %. Stoga je zaključeno da bi VERU mogao smanjiti emisije plinova iz vozila i iz tog se razloga preporuča njegova uporaba.Vehicle emissions constitute the main source of atmospheric pollution in modern cities. The increasing number of passenger cars, especially during the last decade, has resulted in composite traffic problems with serious consequences on emissions and fuel consumption. The main focus is on the development of a unit to reduce the constituents of vehicle emissions before they get into the atmosphere. The Vehicle Emissions Reduction Unit (VERU) was used to absorb certain percentages of carbon dioxide (CO2), carbon monoxide (CO), and hydrocarbons (HC) which would have been emitted into the atmosphere. The VERU consists of a canister and specimen prepared by mixing clay with soda lime and water and rolled into balls which were then sun dried. The sun dried specimen were placed in the canister and applied at the tail end of exhaust pipes of vehicles. The results of the tests carried out using VERU showed that CO2 was reduced by 60%, CO by 73%, HC by 80%, while O2 was increased by 150%. It was concluded that the use of VERU could reduce vehicle emissions and is therefore recommended for use

Performance of a cardiac lipid panel compared to four prognostic scores in chronic heart failure

The cardiac lipid panel (CLP) is a novel panel of metabolomic biomarkers that has previously shown to improve the diagnostic and prognostic value for CHF patients. Several prognostic scores have been developed for cardiovascular disease risk, but their use is limited to specific populations and precision is still inadequate. We compared a risk score using the CLP plus NT-proBNP to four commonly used risk scores: The Seattle Heart Failure Model (SHFM), Framingham risk score (FRS), Barcelona bio-HF (BCN Bio-HF) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score. We included 280 elderly CHF patients from the Cardiac Insufficiency Bisoprolol Study in Elderly trial. Cox Regression and hierarchical cluster analysis was performed. Integrated area under the curves (IAUC) was used as criterium for comparison. The mean (SD) follow-up period was 81 (33) months, and 95 (34%) subjects met the primary endpoint. The IAUC for FRS was 0.53, SHFM 0.61, BCN Bio-HF 0.72, MAGGIC 0.68, and CLP 0.78. Subjects were partitioned into three risk clusters: low, moderate, high with the CLP score showing the best ability to group patients into their respective risk cluster. A risk score composed of a novel panel of metabolite biomarkers plus NT-proBNP outperformed other common prognostic scores in predicting 10-year cardiovascular death in elderly ambulatory CHF patients. This approach could improve the clinical risk assessment of CHF patients

Performance of a cardiac lipid panel compared to four prognostic scores in chronic heart failure

The cardiac lipid panel (CLP) is a novel panel of metabolomic biomarkers that has previously shown to improve the diagnostic and prognostic value for CHF patients. Several prognostic scores have been developed for cardiovascular disease risk, but their use is limited to specific populations and precision is still inadequate. We compared a risk score using the CLP plus NT-proBNP to four commonly used risk scores: The Seattle Heart Failure Model (SHFM), Framingham risk score (FRS), Barcelona bio-HF (BCN Bio-HF) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score. We included 280 elderly CHF patients from the Cardiac Insufficiency Bisoprolol Study in Elderly trial. Cox Regression and hierarchical cluster analysis was performed. Integrated area under the curves (IAUC) was used as criterium for comparison. The mean (SD) follow-up period was 81 (33) months, and 95 (34%) subjects met the primary endpoint. The IAUC for FRS was 0.53, SHFM 0.61, BCN Bio-HF 0.72, MAGGIC 0.68, and CLP 0.78. Subjects were partitioned into three risk clusters: low, moderate, high with the CLP score showing the best ability to group patients into their respective risk cluster. A risk score composed of a novel panel of metabolite biomarkers plus NT-proBNP outperformed other common prognostic scores in predicting 10-year cardiovascular death in elderly ambulatory CHF patients. This approach could improve the clinical risk assessment of CHF patients

Performance of a cardiac lipid panel compared to four prognostic scores in chronic heart failure

The cardiac lipid panel (CLP) is a novel panel of metabolomic biomarkers that has previously shown to improve the diagnostic and prognostic value for CHF patients. Several prognostic scores have been developed for cardiovascular disease risk, but their use is limited to specific populations and precision is still inadequate. We compared a risk score using the CLP plus NT-proBNP to four commonly used risk scores: The Seattle Heart Failure Model (SHFM), Framingham risk score (FRS), Barcelona bio-HF (BCN Bio-HF) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score. We included 280 elderly CHF patients from the Cardiac Insufficiency Bisoprolol Study in Elderly trial. Cox Regression and hierarchical cluster analysis was performed. Integrated area under the curves (IAUC) was used as criterium for comparison. The mean (SD) follow-up period was 81 (33) months, and 95 (34%) subjects met the primary endpoint. The IAUC for FRS was 0.53, SHFM 0.61, BCN Bio-HF 0.72, MAGGIC 0.68, and CLP 0.78. Subjects were partitioned into three risk clusters: low, moderate, high with the CLP score showing the best ability to group patients into their respective risk cluster. A risk score composed of a novel panel of metabolite biomarkers plus NT-proBNP outperformed other common prognostic scores in predicting 10-year cardiovascular death in elderly ambulatory CHF patients. This approach could improve the clinical risk assessment of CHF patients