Schulze J, van den Bussche H, Glaeske G, Kaduszkiewicz H, Wiese B, Hoffmann F. patients died during the observation period. Full data sets from 344 patients were used for Cox regression analysis. Male sex, older age, lower BMI, use of neuroleptic medicine, peripheral artery disease, and elevated plasma concentrations of ADMA, NT pro\BNP, and CRP were significant predictors of mortality. Conclusion The concentration of ADMA and NT pro\BNP may be used as an early risk marker for overall mortality in geriatric care. Neuroleptic medicine is associated with increased mortality in this population. strong class=”kwd-title” Keywords: ADMA, geriatric care, overall mortality, risk markers 1.?INTRODUCTION The use of predictive markers in the ageing population at risk is getting more important. Older patients represent a vulnerable population group with a particularly high prevalence of co\morbidities and mortality.1 Cardiovascular (CV) disease is the leading cause of death and disability among these patients; however, robust biomarkers are not generally established. Plasma asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO). ADMA and its symmetric isomer SDMA are novel predictors for CV disease, chronic kidney disease and mortality.2 N\terminal pro\brain natriuretic peptide (NT pro\BNP) provides prognostic information for CV events and mortality in the older patients.3 C\reactive protein (CRP) is a sensitive acute phase reactant and is used as prognostic marker in patients with CV disease.4, 5 These cardiac risk markers as well as body mass index (BMI) have emerged as promising tools for risk estimate of older patients,6, 7 but have not been established in geriatric care. Since limited trial data are available for the combined use of CV risk markers in an older population, we aimed to investigate the prognostic value of age, sex, BMI, co\medication and CV laboratory risk markers in long\term geriatric care patients aged 65?years. 2.?MATERIALS AND METHODS The study protocol was approved by the Ethics Committee of the Medical University of Vienna (EK 511\2008) and conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained before study entry from all patients or their legal representatives, respectively. 2.1. Study protocol In this prospective observational single\centre cohort study all long\term geriatric care residents of the Haus der Barmherzigkeit Vienna, Austria were screened for eligibility between 14.09.2009 and 16.12.2009. All patients who were hospitalized for at least 1?month in geriatric care were included. Patients with symptomatic heart failure were excluded. The observation period was defined with a maximum of 90?months and mortality was identified from the public register of death certificates. Demographic data including age, sex, admission diagnosis, height and weight were collected. ADMA, SDMA, L\arginine, NT pro\BNP and CRP were determined at study entry from leftovers of routine venous blood samples. Plasma was separated after centrifugation and stored at ?80C until batch analysis. 2.2. Laboratory assays Quantification of arginines was performed by high\performance liquid chromatography (HPLC) as described previously.8 The coefficients of variation for inter\ and intra\assay variations are 3% for all analyses. The detection limit for (methyl\) arginines is 0.04?mol/L. NT pro\BNP measurements were performed according to standard procedures using an assay by Roche Diagnostics (Eleccsys? NT pro\BNP, Cobas, Rotkreuz, Switzerland). The analytical sensitivity of the kit is 0.063?ng/mL, assay range 0.31\10?ng/mL, and the intra\assay CV is 5.5%. Serum levels of CRP were quantified using a Human Solid Phase Sandwich ELISA from R&D Systems (Wiesbaden, Germany) with a lower limit of quantification of 0.1?mg/dL. 2.3. Statistical analysis Metric variables are expressed as mean, and standard deviation (SD). Simple associations of risk factors for survival period were explored by Spearman correlation coefficient. Only data from patients with full set of laboratory CV risk parameters were used. Significant univariate predictors for.Predictors of Long\Term Mortality in Older Patients Hospitalized for Acutely Decompensated Heart Failure: clinical Relevance of Natriuretic Peptides. predictors for survival period were used in the Cox proportional hazard model. Results A total of 481 patients were screened, and data from 449 patients were analysed. A total of 381 patients died during the observation period. Full data sets from 344 Latanoprostene bunod patients were used for Cox regression analysis. Male sex, older age, lower BMI, use of neuroleptic medicine, peripheral artery disease, and elevated plasma concentrations of ADMA, NT pro\BNP, and CRP were significant predictors of mortality. Conclusion The concentration of ADMA and NT pro\BNP may be used as an early risk marker for overall mortality in geriatric care. Neuroleptic medicine is associated with increased mortality in this population. strong class=”kwd-title” Keywords: ADMA, geriatric care, overall mortality, risk markers 1.?INTRODUCTION The use of predictive markers in the ageing population at risk is getting more important. Older patients represent a vulnerable population group with a particularly high prevalence of co\morbidities and mortality.1 Cardiovascular (CV) disease is the leading cause of death and disability among these patients; however, robust biomarkers are not generally established. Plasma asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO). ADMA and its symmetric isomer SDMA are novel predictors for CV disease, chronic kidney disease and mortality.2 N\terminal pro\brain natriuretic peptide (NT pro\BNP) provides prognostic information for CV events and mortality in the older patients.3 C\reactive protein (CRP) is a sensitive acute phase reactant and is used as prognostic marker in patients with CV disease.4, 5 These cardiac risk markers as well as Latanoprostene bunod body mass index (BMI) have emerged as promising tools for risk estimate of older patients,6, 7 but have not been established in geriatric care. Since limited trial data are available for the combined use of CV risk markers in an older population, we aimed to investigate the prognostic value of age, sex, BMI, co\medication and CV laboratory risk markers in long\term geriatric care patients aged 65?years. 2.?MATERIALS AND METHODS The study protocol was approved by the Ethics Committee of the Medical University or college of Vienna (EK 511\2008) and conducted in accordance with the Declaration of Helsinki. Written educated consent was acquired before study access from all individuals or their legal associates, respectively. 2.1. Study protocol With this prospective observational solitary\centre cohort study all long\term geriatric care residents of the Haus der Barmherzigkeit Vienna, Austria were screened for eligibility between 14.09.2009 and 16.12.2009. All individuals who have been hospitalized for at least 1?month in geriatric care were included. Individuals with symptomatic heart failure were excluded. The observation period was defined with a maximum of 90?weeks and mortality was identified from the public register of death certificates. Demographic data including age, sex, admission analysis, height and excess weight were collected. ADMA, SDMA, L\arginine, NT pro\BNP and CRP were determined at study access from leftovers of routine venous blood samples. Plasma was separated after centrifugation and stored at ?80C until batch analysis. 2.2. Laboratory assays Quantification of arginines was performed by high\overall performance liquid chromatography (HPLC) as explained previously.8 The coefficients of variation for inter\ and intra\assay variations are 3% for those analyses. The detection limit for (methyl\) arginines is definitely 0.04?mol/L. NT pro\BNP measurements were performed relating to standard methods using an assay by Roche Diagnostics (Eleccsys? NT pro\BNP, Cobas, Rotkreuz, Switzerland). The analytical level of sensitivity of the kit is definitely 0.063?ng/mL, assay range 0.31\10?ng/mL, and the intra\assay CV is 5.5%. Serum levels of CRP were quantified using a Human being Solid Phase Sandwich ELISA from R&D Systems (Wiesbaden, Germany) with a lower limit of quantification of 0.1?mg/dL. 2.3. Statistical analysis Metric variables are indicated as mean, and standard deviation (SD). Simple associations of risk factors for survival period were explored by Spearman correlation coefficient. Only data from individuals with full set of laboratory CV risk guidelines were used. Significant univariate predictors for survival period were used in the Cox proportional risk model. With this model, significant variables were determined by backward selection. In all analyses a em P /em \value of 0.05 was considered significant. All statistical calculations were performed using SPSS Version 19.0 (SPSS Inc., Chicago, IL, USA). 3.?RESULTS In total, 481 individuals were screened for eligibility and data from 449 individuals aged between 65 and 105?years were available for analysis (Numbers?1 and ?and2).2). Baseline characteristics are offered in Furniture?1 and ?and2.2. A total of 381 individuals died during the observation period of 90?weeks. The cumulative survival of female.[PMC free article] [PubMed] [Google Scholar] 26. for survival period were explored by Spearman correlation coefficient. Significant univariate predictors for survival period were used in the Cox proportional risk model. Results A total of 481 individuals were screened, and data from 449 individuals were analysed. A total of 381 individuals died during the observation period. Full data units from 344 individuals were utilized for Cox regression analysis. Male sex, older age, lower BMI, use of neuroleptic medicine, peripheral artery disease, and elevated plasma concentrations of ADMA, NT pro\BNP, and CRP were significant predictors of mortality. Summary The concentration of ADMA and NT pro\BNP may be used as an early risk marker for overall mortality in geriatric care. Neuroleptic medicine is associated with improved mortality with this human population. strong class=”kwd-title” Keywords: ADMA, geriatric care and attention, overall mortality, risk markers 1.?Intro The use of predictive markers in the ageing human population at risk is getting more important. Older individuals represent a vulnerable human population group with a particularly high prevalence of co\morbidities and mortality.1 Cardiovascular (CV) disease is the leading cause of death and disability among these individuals; however, powerful biomarkers are not generally founded. Plasma asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO). ADMA and its symmetric isomer SDMA are novel predictors Latanoprostene bunod for CV disease, Latanoprostene bunod chronic kidney disease and mortality.2 N\terminal pro\mind natriuretic peptide (NT pro\BNP) provides prognostic info for CV events and mortality in the older individuals.3 C\reactive protein (CRP) is a sensitive acute phase reactant and is used as prognostic marker in individuals with CV disease.4, 5 Latanoprostene bunod These cardiac risk markers as well while body mass index (BMI) have emerged while promising tools for risk estimate of older individuals,6, 7 but have not been established in geriatric care. Since limited trial data are available for the combined use of CV risk markers in an older human population, we aimed to investigate the prognostic value of age, sex, BMI, co\medication and CV laboratory risk markers in long\term geriatric care individuals aged 65?years. 2.?MATERIALS AND METHODS The study protocol was approved by the Ethics Committee of the Medical University or college of Vienna (EK 511\2008) and conducted in accordance with the Declaration of Helsinki. Written educated consent was acquired before study access from all individuals or their legal associates, respectively. 2.1. Study protocol With this prospective observational solitary\centre cohort study all long\term geriatric care residents of the Haus der Barmherzigkeit Vienna, Austria were screened for eligibility between 14.09.2009 and 16.12.2009. All individuals who have been hospitalized for at least 1?month in geriatric care were included. Individuals with symptomatic heart failure were excluded. The observation period was defined with a maximum of 90?weeks and mortality was identified from the public register of death certificates. Demographic data including age, sex, admission analysis, height and excess weight were collected. ADMA, SDMA, L\arginine, NT pro\BNP and CRP were determined at study access from leftovers of routine venous blood samples. Plasma was separated after centrifugation and stored at ?80C until batch analysis. 2.2. Laboratory assays Quantification of arginines was performed by high\overall performance liquid chromatography (HPLC) as explained previously.8 The coefficients of variation for inter\ and intra\assay variations are 3% for those analyses. The detection limit for (methyl\) arginines is definitely 0.04?mol/L. Rabbit Polyclonal to RPS19BP1 NT pro\BNP measurements were performed relating to standard methods using an assay by Roche Diagnostics (Eleccsys? NT pro\BNP, Cobas, Rotkreuz, Switzerland). The analytical level of sensitivity of the kit is definitely 0.063?ng/mL, assay range 0.31\10?ng/mL, and the intra\assay CV is 5.5%. Serum levels of CRP were quantified using a Human being Solid Phase Sandwich ELISA from R&D Systems (Wiesbaden, Germany) with a lower limit of quantification of 0.1?mg/dL. 2.3. Statistical analysis Metric variables are indicated as mean, and standard deviation (SD). Simple.