Multi-biomarker strategy for prediction of myocardial dysfunction and mortality in sepsis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

ABSTRACT

OBJECTIVE@#The present study was to evaluate the feasibility of using the multi-biomarker strategy for the prediction of sepsis-induced myocardial dysfunction (SIMD) and mortality in septic patients.@*METHODS@#Brain natriuretic peptide (BNP), cardiac troponin I (cTnI), and heart-type fatty acid-binding protein (h-FABP) in 147 septic patients were assayed within 6 h after admission. We also determined the plasma levels of myeloperoxidase (MPO) and pregnancy-associated plasma protein-A (PAPP-A). The receiver operating characteristic (ROC) curve was used to assess the best cutoff values of various single-biomarkers for the diagnosis of SIMD and the prediction of mortality. Also, the ROC curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) indices were used to evaluate the feasibility of using multi-biomarkers to predict SIMD and mortality.@*RESULTS@#Our statistics revealed that only h-FABP independently predicted SIMD (P0.05). A history of shock and MPO were independent predictors of mortality in septic patients (both P0.05).@*CONCLUSIONS@#The findings of this study indicate that a sensitive and specific strategy for early diagnosis of SIMD and mortality prediction in sepsis should incorporate three biomarkers.