None listed
Conditions
Brief summary
There is a pressing need for additional tools to help differentiate heart failure from other causes of dyspnea in acutely short of breath patients, and to improve our ability to provide accurate prognostic information and sound therapeutic management to heart failure patients. Where ADHF is the primary cause of dyspnoea, plasma BNP is a proven diagnostic adjunct. However, where pneumonia and ADHF co-exist, lack of specific pneumonic findings can delay appropriate introduction of antibiotic therapy. Misdiagnosis or delay in the introduction of appropriate therapy leads to significant morbidity and mortality from respiratory/circulatory failure and septicaemia. There is a need for biomarkers that can; 1) assist in the rapid diagnosis of pneumonia in ADHF, 2) assist in the prediction of who may be at risk of serious pneumonia-related complications and 3) aid the decision to administer antibiotic therapy where there is suspicion of pneumonia present in ADHF. The SIGNIFICANT-HF Study is an initiative to assess a new and unique biological markers in an acute shortness of breath population. 1200 people presenting to the Christchurch Hospital Emergency Department with non-traumatic shortness of breath will be invited to participate. 3 additional blood samples will be collected during admission for analysis of the levels of these newly identified heart hormones.
Interventions
We will recruit 2000 patients presenting to the Emergency Department (ED) of Christchurch Hospital with the primary complaint of breathlessness.
Blood samples will be taken at presentation in the ED, at 24 hours and at discharge to test the diagnostic performance of Ghrelin signal peptide (GHRsp) and Neutrophil gelatinase associated lipocalin signal peptide (NGALsp) against and alongside N-terminal of the prohormone brain natriuretic peptide (NTproBNP) and procalcitonin (PCT) for the diagnosis
We will recruit 2000 patients presenting to the Emergency Department (ED) of Christchurch Hospital with the primary complaint of breathlessness. Blood samples will be taken at presentation in the ED, at 24 hours and at discharge to test the diagnostic performance of Ghrelin signal peptide (GHRsp) and Neutrophil gelatinase associated lipocalin signal peptide (NGALsp) against and alongside N-terminal of the prohormone brain natriuretic peptide (NTproBNP) and procalcitonin (PCT) for the diagnosis of pneumonia, HF and concurrent pneumonia and HF. Patients will be followed up at 30 and 90 days and 1 year to allow for assessment of prognostic power of GHRsp and NGALsp to predict subsequent events.All diagnoses will undergo standardised adjudication by two clinicians blinded to marker results.
Sponsors
Christchurch Heart Institute. University of Otago
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Eligible patients who report shortness of breath not due to trauma as their primary complaint upon presentation to the ED.
Exclusion criteria
Patients under 18 years of age or unable to provide consent are excluded. Patients with an acute ST-elevation myocardial infarction and patients on haemodialysis for renal failure are also excluded.
Outcome results
None listed