IJCA-21948; No of Pages 2 International Journal of Cardiology xxx (2016) xxx–xxx
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Correspondence
Response to letter: Device therapy and aldosterone antagonists in the prognosis of heart failure Michael Behnes a,⁎, Thomas Bertsch e, Christel Weiss a,c, Parviz Ahmad-Nejad d, Ibrahim Akin a, Christian Fastner a, Ibrahim El-Battrawy a, Siegfried Lang a, Michael Neumaier a,b, Martin Borggrefe a, Ursula Hoffmann a a
First Department of Medicine, University Medical Centre Mannheim (UMM), Mannheim, Germany Institute for Clinical Chemistry, University Medical Centre Mannheim (UMM), Mannheim, Germany c Department for Statistical Analysis, University Medical Centre Mannheim (UMM), Mannheim, Germany d Institute for Microbiology and Laboratory Medicine, HELIOS Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany e Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany b
a r t i c l e
i n f o
Article history: Received 13 January 2016 Accepted 15 January 2016 Available online xxxx
Notably, the results of our study, that galectin-3, osteopontin and gremlin-1 may have different prognostic value in our heart failure population, are not influenced by the treatment with aldosterone antagonists or cardiac devices, revealing the beneficial prognostic value of the three fibrotic biomarkers in naive suspected and proven heart failure patients. For sure, our results need to be re-evaluated in heart failure populations with the currently recommended therapies. Conflict of interest
Dear Editor, We are grateful to Dr. Eyuboglu for his interest in our recent publication [1]. We agree that the treatment with aldosterone antagonists and cardiac devices such as implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) improves the prognosis of patients suffering from heart failure by reducing significantly mortality, as being demonstrated by several studies and recommended by current European Guidelines [2–4]. Current recommendations of European guidelines are included and adapted continuously within daily clinical practice specifically for heart failure patients at our University Clinic. However, the rate of patients with a severely reduced ejection fraction of b35% was only 12% within our initial study cohort [5,6]. Additionally, our study population was recruited in the years from 2005 to 2006, when at least aldosterone antagonists were recommended only for patients with heart failure symptoms at New York Heart Association (NYHA) stage III. Therefore, the rates of these treatments with aldosterone antagonists and cardiac devices were lower compared to today's clinical practice and presumably the beneficial effects of these therapies can be disregarded in our initial study population. However, these were offered to our patients during their individual follow-up of 5 years or even later.
⁎ Corresponding author at: First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, TheodorKutzer-Ufer 1-3, 68167 Mannheim, Germany. E-mail address: [email protected] (M. Behnes).
The authors report no relationships that could be construed as a conflict of interest. Disclosures None. Acknowledgments All authors declare that they do not have any potential conflicts of interest. References [1] M. Behnes, et al., Triple head-to-head comparison of fibrotic biomarkers galectin-3, osteopontin and gremlin-1 for long-term prognosis in suspected and proven acute heart failure patients, Int. J. Cardiol. 203 (2016) 398–406. [2] Authors/Task Force, M., et al., 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC) endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), Eur. Heart J. (2015). [3] M. Brignole, et al., 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA), Eur. Heart J. 34 (29) (2013) 2281–2329. [4] J.J. McMurray, et al., ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology. Developed in
http://dx.doi.org/10.1016/j.ijcard.2016.01.193 0167-5273/© 2016 Elsevier Ireland Ltd. All rights reserved.
Please cite this article as: M. Behnes, et al., Response to letter: Device therapy and aldosterone antagonists in the prognosis of heart failure, Int J Cardiol (2016), http://dx.doi.org/10.1016/j.ijcard.2016.01.193
2
M. Behnes et al. / International Journal of Cardiology xxx (2016) xxx–xxx
collaboration with the Heart Failure Association (HFA) of the ESC, Eur. J. Heart Fail. 14 (8) (2012) 803–869. [5] M. Behnes, M. Brueckmann, P. Ahmad-Nejad, S. Lang, C. Wolpert, E. Elmas, et al., Diagnostic performance and cost effectiveness of measurements of plasma N-terminal pro brain natriuretic peptide in patients presenting with acute dyspnea or peripheral edema, Int J Cardiol. 135 (2) (2009) 165–174.
[6] M. Behnes, S. Lang, O.A. Breithardt, J.J. Kaden, D. Haghi, P. Ahmad-Nejad, et al., Association of NT-proBNP with severity of heart valve disease in a medical patient population presenting with acute dyspnea or peripheral edema, J Heart Valve Dis. 17 (5) (2008) 557–565.
Please cite this article as: M. Behnes, et al., Response to letter: Device therapy and aldosterone antagonists in the prognosis of heart failure, Int J Cardiol (2016), http://dx.doi.org/10.1016/j.ijcard.2016.01.193
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Correspondence
Response to letter: Device therapy and aldosterone antagonists in the prognosis of heart failure Michael Behnes a,⁎, Thomas Bertsch e, Christel Weiss a,c, Parviz Ahmad-Nejad d, Ibrahim Akin a, Christian Fastner a, Ibrahim El-Battrawy a, Siegfried Lang a, Michael Neumaier a,b, Martin Borggrefe a, Ursula Hoffmann a a
First Department of Medicine, University Medical Centre Mannheim (UMM), Mannheim, Germany Institute for Clinical Chemistry, University Medical Centre Mannheim (UMM), Mannheim, Germany c Department for Statistical Analysis, University Medical Centre Mannheim (UMM), Mannheim, Germany d Institute for Microbiology and Laboratory Medicine, HELIOS Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany e Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany b
a r t i c l e
i n f o
Article history: Received 13 January 2016 Accepted 15 January 2016 Available online xxxx
Notably, the results of our study, that galectin-3, osteopontin and gremlin-1 may have different prognostic value in our heart failure population, are not influenced by the treatment with aldosterone antagonists or cardiac devices, revealing the beneficial prognostic value of the three fibrotic biomarkers in naive suspected and proven heart failure patients. For sure, our results need to be re-evaluated in heart failure populations with the currently recommended therapies. Conflict of interest
Dear Editor, We are grateful to Dr. Eyuboglu for his interest in our recent publication [1]. We agree that the treatment with aldosterone antagonists and cardiac devices such as implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) improves the prognosis of patients suffering from heart failure by reducing significantly mortality, as being demonstrated by several studies and recommended by current European Guidelines [2–4]. Current recommendations of European guidelines are included and adapted continuously within daily clinical practice specifically for heart failure patients at our University Clinic. However, the rate of patients with a severely reduced ejection fraction of b35% was only 12% within our initial study cohort [5,6]. Additionally, our study population was recruited in the years from 2005 to 2006, when at least aldosterone antagonists were recommended only for patients with heart failure symptoms at New York Heart Association (NYHA) stage III. Therefore, the rates of these treatments with aldosterone antagonists and cardiac devices were lower compared to today's clinical practice and presumably the beneficial effects of these therapies can be disregarded in our initial study population. However, these were offered to our patients during their individual follow-up of 5 years or even later.
⁎ Corresponding author at: First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, TheodorKutzer-Ufer 1-3, 68167 Mannheim, Germany. E-mail address: [email protected] (M. Behnes).
The authors report no relationships that could be construed as a conflict of interest. Disclosures None. Acknowledgments All authors declare that they do not have any potential conflicts of interest. References [1] M. Behnes, et al., Triple head-to-head comparison of fibrotic biomarkers galectin-3, osteopontin and gremlin-1 for long-term prognosis in suspected and proven acute heart failure patients, Int. J. Cardiol. 203 (2016) 398–406. [2] Authors/Task Force, M., et al., 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC) endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), Eur. Heart J. (2015). [3] M. Brignole, et al., 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA), Eur. Heart J. 34 (29) (2013) 2281–2329. [4] J.J. McMurray, et al., ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology. Developed in
http://dx.doi.org/10.1016/j.ijcard.2016.01.193 0167-5273/© 2016 Elsevier Ireland Ltd. All rights reserved.
Please cite this article as: M. Behnes, et al., Response to letter: Device therapy and aldosterone antagonists in the prognosis of heart failure, Int J Cardiol (2016), http://dx.doi.org/10.1016/j.ijcard.2016.01.193
2
M. Behnes et al. / International Journal of Cardiology xxx (2016) xxx–xxx
collaboration with the Heart Failure Association (HFA) of the ESC, Eur. J. Heart Fail. 14 (8) (2012) 803–869. [5] M. Behnes, M. Brueckmann, P. Ahmad-Nejad, S. Lang, C. Wolpert, E. Elmas, et al., Diagnostic performance and cost effectiveness of measurements of plasma N-terminal pro brain natriuretic peptide in patients presenting with acute dyspnea or peripheral edema, Int J Cardiol. 135 (2) (2009) 165–174.
[6] M. Behnes, S. Lang, O.A. Breithardt, J.J. Kaden, D. Haghi, P. Ahmad-Nejad, et al., Association of NT-proBNP with severity of heart valve disease in a medical patient population presenting with acute dyspnea or peripheral edema, J Heart Valve Dis. 17 (5) (2008) 557–565.
Please cite this article as: M. Behnes, et al., Response to letter: Device therapy and aldosterone antagonists in the prognosis of heart failure, Int J Cardiol (2016), http://dx.doi.org/10.1016/j.ijcard.2016.01.193
