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Recent News and Articles on the Keywords: 155,000 + hospital + web  Related to the article below (Last Update: 8/5/2008)

Blood Test Predicts Mortality in Hospitalized Heart Failure Patients

A simple blood test — beyond standard lab tests — taken at hospital admission strongly predicted in-hospital mortality risk for heart failure patients and may be useful in helping doctors decide which patients need higher-level monitoring and more intensive treatment.

Published in the May 15 issue of the Journal of the American College of Cardiology, the study findings show that the blood level of B-type natriuretic peptide (BNP), a neurohormone released by the heart when it is stressed or damaged, provided a direct relationship with in-hospital mortality. Researchers found that higher BNP levels at admission were predictive of higher in-hospital mortality rates.

“We hope the findings will help physicians more effectively stratify risk and guide treatment. This is the first study to definitively demonstrate a connection between BNP and in-hospital mortality risk among heart failure patients,” said principal investigator Dr. Gregg C. Fonarow, UCLA’s Eliot Corday Chair in Cardiovascular Medicine and Science, professor of cardiology and director of the Ahmanson–UCLA Cardiomyopathy Center. “This is also the largest biomarker study in heart failure ever conducted.”

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The relationship between BNP and mortality persisted independent of other clinical and laboratory factors and held true for hospitalized heart failure patients with either reduced or preserved systolic function, which is the ability of the heart’s left ventricle to pump blood to the body’s other organs.

The researchers utilized data on 48,629 out of 77,467 heart failure patients whose BNP levels were taken within 24 hours of hospital admission. The patient data, collected between April 2003 and December 2004 at 191 hospitals across the country, is part of the Acute Decompensated Heart Failure National Registry (ADHERE), a U.S. registry of heart failure patients.

Investigators assessed in-hospital mortality and placed the patients in four groups depending on their BNP level:
• The first group had low BNP levels — less than 430 pg/ml (picograms per milliliter) — and a corresponding mortality rate of 1.9 percent.
• The second group of patients had BNP levels between 430 and 839 pg/ml, with a corresponding mortality rate of 2.8 percent.
• The third group had BNP levels between 840 to 1,729 pg/ml, with a mortality rate of 3.8 percent.
• The fourth group had the highest BNP levels — 1,730 pg/ml or more — and the highest mortality rate, 6 percent.

“We were very surprised that this blood test was so highly predictive of mortality across a broad population of heart failure patients and range of BNP levels,” said Fonarow.

Researchers found BNP levels remained predictive of mortality even after adjustment for age, gender, systolic blood pressure, pulse and other lab tests, such as blood urea nitrogen, creatinine and sodium.

Higher BNP levels were also predictive of other clinical outcomes, such as the need for mechanical ventilation, the length of the hospital stay and the amount of time spent in the intensive care unit.

Fonarow said that BNP levels may be a useful addition to routine assessment and can help guide care and treatment of patients hospitalized with acute heart failure. He noted that a BNP test provides quick results, often within 15 minutes to a few hours, which can provide physicians with additional information to help in medical decision-making.

The next step will be further research to demonstrate that patients with higher BNP levels at admission benefit from more intensive monitoring and treatment.

The study was funded by the biopharmaceutical company Scios Inc., which sponsors the ADHERE registry. Fonarow and co-authors have received research grants and speaking fees from Scios and have served as consultants for the company.

Other study authors include: Dr. William F. Peacock of the department of emergency medicine at the Cleveland Clinic Foundation in Cleveland, Ohio; Dr. Christopher O. Phillips of the department of medicine at the Cleveland Clinic Foundation; Dr. Michael M. Givertz of the department of medicine at Brigham and Women’s Hospital in Boston, Mass.; and Margarita Lopatin, M.S., department of biostatistics at Scios Inc. in Mountain View, Calif.

Endocrine Test Categories

We are very pleased to provide you this very comprehensive list of tests for pituitary/hormonal disorders. The list has been provided courtesy of Quest Laboratories but has been edited and checked by Professor Shereen Ezzat, University of Toronto, Canada and Professor Aart van derLeily, Erasmus University, Rotterdam, the Netherlands. Clearly each possible test must be prescribed by your physician and the results evaluated by him/her.

Not every test is needed for each patient, nor will we presume to tell you where you should measure on any scale. That is medical information we are in no position to evaluate and weigh. However, this will hopefully give you a guide to discuss with your doctor(s). And remember--no two lab tests EVER come out the same AND different laboratories have different "mean" and measurements. The laboratory, the doctor and the technician MUST be thoroughly familiar with these types of tests. Failure to conduct proper laboratory tests and analysis may be very, very detrimental to your health, treatment and recovery.

Categories

Adrenocortical Function

11-Deoxycortisol (Compound S)
17-Hydroxycorticosteroids, 24-Hour Urine
17-Hydroxypregnenolone
17-Hydroxyprogesterone
17-Ketogenic Steroids, 24-Hour Urine
17-Ketosteroids, 24-Hour Urine
18-Hydroxycorticosterone
18-Hydroxydeoxycorticosterone
3a-Androstanediol Glucuronide (3a diol G)
5-HIAA (5-Hydroxyindoleacetic acid), Urine
6B Hydroxycortisol, 24-hour Urine
ACTH by ICMA or RIA
Aldosterone, Serum
Aldosterone, Urine
Androstenedione
Antiadrenal Antibody
Corticosterone
Corticotropin Releasing Hormone (CRH)
Cortisol Binding Globulin (Transcortin)
Cortisol, Free, 24-hour Urine
Cortisol, Free, Serum or Plasma
Cortisol, Serum
Cortisone, Serum
Cortisone, Urine
Deoxycorticosterone
Dexamethasone
DHEA (Dehydroepiandrosterone)
DHEA Sulfate
Dihydrotestosterone
Dihydrotestosterone, Free, Serum
Endorphin (Beta Endorphin/Lipotropin)
Pregnanediol Glucuronide, 24-hour urine
Pregnenolone
Progesterone, Serum
Sex Hormone Binding Globulin
Somatostatin
Testosterone, Adjusted
Testosterone, bioavailable
Testosterone, Free
Testosterone, Total
Testosterone, Total, Male

Catecholamines

Catecholamines, Plasma
Catecholamines, Urine
Chromogranin A
homovanillic Acid, Urine
Metanephrines, Random Urine
Metanephrines, total, 24-hour Urine
VMA, Urine

Endocrine Autoimmunity

Anti-PTH Antibody
Anti-T3 Autoantibody
Anti-T4 Autoantibody
Anti-TSH Autoantibody
Antiadrenal Antibody
Anticalcitonin Antibody
Antigliadin Antibody Panel
Antiglomerular Basement Membrane (Anti-GBM)
Antiparietal Cell Antibody
Antithyroglobulin Antibody
Antithyroid Peroxidase Antibody (Anti-TPO)
CSI (Collagen Stimulating Immunoglobulin)
Growth Hormone Antibody
Insulin Antibodies
Insulin Antibodies, Highly Sensitive
Insulin Receptor Antibody
Islet Cell Antibody
TBII (Thyrotropin-binding Inhibitory Immunoglobulin)
TGI (Thyroid Growth Stimulating Immunoglobulin)
Thyrotropin blocking Antibody
TSI (Thyroid Stimulating Immunoglobulin)

Fluid, Electrolyte, and Renal

18-Hydroxycorticosterone
18-Hydroxydeoxycorticosterone
Aldosterone, 24-Hour Urine
Aldosterone, Serum
Angiotensin Converting Enzyme (ACE)
Angiotensin II
Antiglomerular Basement Membrane (Anti-GBM)
Arginine Vasopressin (AVP, ADH), Plasma
Arginine Vasopressin and Osmolality, Urine
Atrial Natriuretic Hormone (Atrial Natriuretic Factor)
Corticosterone
Cortisol Binding Globulin (Transcortin)
Cortisol, Free, 24-Hour Urine
Cortisol, Free, Serum or Plasma
Cortisol, Serum
Cortisone, Serum
Cortisone, Urine
Deoxycorticosterone
Endothelin
Erythropoietin*
Osmolality, Random Urine
Osmolality, Serum
Plasma Renin (Direct)
Plasma Renin Activity
Prorenin
Renin Substrate
Renin, Immunoreactive or Direct
Somatostatin

Metabolic and Gastrointestinal Disorders

5-HIAA (5-Hydroxyindoleacetic Acid) Urine
Apolipoprotein A1
Apolipoprotein B
C-peptide, Plasma
C-Peptide, 24-hour Urine
Cholesterol, Direct LDL
Cholesterol, HDL
Cholesterol, HDL Subclasses
Cholesterol, Total
Fructosamine
Gastrin
Glucagon
Glycated Albumin
Glycated Hemoglobin, Affinity (Total Hgb A1)
Glycated Hemoglobin, HPLC (Hgb A1 and Hgb A1c)
Hemoglobin A 1c HPLC
Hemoglobin, Plasma
IGF Binding Protein-1 (IGFBP-1)
IGF Binding Protein-2 (IGFBP-2)
IGF Binding Protein-3 (IGFBP-3)
IGF-1 (Somatomedin-C), Extraction
IGF-II (Insulin Like Growth Factor II)
Insulin
Insulin Antibodies
Insulin Antibodies, Highly Sensitive
Insulin Receptor Antibody
Insulin, Free
Insulin, Total
Islet Cell Antibody
Magnesium, RBC and Plasma
Magnesium, Serum
Magnesium, Urine
Microalbumin, 24-Hour Urine
Microalbumin, Random Urine
Pancreatic Polypeptide
Pepsinogen 1
Proinsulin
Prorenin
Somatostatin
Triglycerides
Vaasoactive Intestinal Polypeptide (VIP)

Gonadal Function

17-hydroxypregnenoline
17-hydroxyprogesterone
17-Ketogenic Steroids, 24-Hour Urine
17-Ketosteroids, 24-Hour Urine
3a-Androstanediol Glucuronide (ea diol G)
Alpha Subunit
Androstenedione
DHEA (Dehydroepiandrosterone)
DHEA Sulfate
Dihydrotesterone
Dihydrotesterone, Free, Serum
Estradiol, bioavailable
Estradiol, Free
Estradiol, Rapid
Estradiol, Serum
Estradiol, Urine
Estriol, Serum
Estriol, Urine
Estrogen Total, 24-Hour Urine
Estrogen, Total, Serum
Estrogens, Fractionated, 24-Hour Urine
Estrogens, Fractionated, Serum
Estrone, Bioavailable, Serum
Estrone, Free, Serum
Estrone, Serum
Estrone, Sulfate
Estrone, Urine
FSH (Follicle Stimulating Hormone)
FSH, 3rd Generation
HCG, Beta Subunit, Quantitative (Pregnancy)
HCG, Beta Subunit, Quantitative (Tumor)
Inhibin*
LH (luteinizing Hormone)
LH, 3rd Generation
Norethindrone
Pregnanediol Glucuronide, 24-Hour Urine
Pregnenolone
Progesterone, Serum
Prolactin
Sex Hormone Binding Globulin
Testosterone, Adjusted
Testosterone, Bioavailable
Testosterone, Free
Testosterone, Total
Testosterone, Total, Male

Growth and Growth Hormone

Antigliadin Antibody Panel
Growth Hormone (HGH)
Growth Hormone (HGH), Hybritech
Growth Hormone Antibody
Growth Hormone Binding Protein
Growth Hormone Releasing Hormone
IGF Binding Protein-1 (IGFBP-1)
IGF Binding Protein-2 (IGFBP-2)
IGF Binding Protein-3 (IGFBP-3)
IGF-1 (Somatomedin-C), Extraction
IGF-II (Insulin-Like Growth Factor II)
Somatoscreen (IGF-I)

Hypothalamic and Pituitary Function

ACTH by ICMA or RIA
Alpha Subunit
Anti-TSH Autoantibody
Arginine Vasopressin (AVP, ADH), Plasma
Arginine Vasopressin and Osmolality, Urine
Corticotropin Releasing Hormone
Endorphin (Beta Endorphine/Lipotropin)
FSH (Follicle Stimulating Hormone)
FSH, 3rd Generation
Growth Hormone Antibody
Growth Hormone (HGH)
Growth Hormone (HGH), Hybritech
Growth Hormone Binding Protein
Growth Hormone Releasing Hormone (GHRH)
LH (Luteinizing Hormone)
LH, 3rd Generation
Oxytocin
Prolactin
Somatostatin
Thyrotropin Releasing Hormone (TRH)
TSH, 3rd Generation
TSH, Highly Sensitive (HS-TSH)

Multiple Endocrine Neoplasma

5-HIAA (5-Hydroxyindoleacetic Acid), Urine
ACTH by ICMA or RIA
C-Peptide, 24-Hour Urine
C-Peptide, Plasma
Calcium, 24-Hour Urine
Calcium, Ionized
Calcium, Total, Serum
Catecholamines, Plasma
Catecholamines, Urine
Chromogranin A
Gastrin
Glucagon
Growth Hormone (HGH)
Growth Hormone (HGH), Hybritech
Homovanillic Acid, Urine
Insulin, Free
Metanephrine, Total, 24-Hour Urine
Metanephrines, Urine
Pancreatic Polypeptide
Proinsulin
Prolactin
PTH C-Terminal (Mid-Molecule)
PTH, Intact (ICMA)
PTH-Related Protein (PTH-RP)
Vasoactive Intestinal Polypeptide (VIP)
VMA, Urine

Parathyroid and Mineral Metabolism

Anti-PTH Antibody
Anticalcitonin Antibody
Calcium, 24-Hour Urine
Calcium, Ionized
Calcium, Total, Serum
Collagen Cross-Linked N-Telepeptide (NTx) Urine
Cyclic Aenosine Monophosphate (Cyclic AMP) Random Urine and Serum
Hydroxyproline, Free, 24-Hour Urine
Hydroxyproline, Plasma
Hydroxyproline, Total, 24-Hour Urine
Magnesium, RBC and Plasma
Magnesium, Serum
Magnesium, Urine
Ostecalcin, Human (Bone gla Protein, BGP)
Procollagen Peptide-Type 1*
PTH C-Terminal (Mid-Molecule)
PTH, Intact (ICMA)
PTH-Related Protein (PTH-RP)
Pyridinium Collagen Cross-Links, 2-Hour Urine
Pyridinium Collagen Cross-Links, 24-Hour Urine
Vitamin D, I, 25-Dihydroxy
Vitamin D, 25-Hydroxy

Thyroid Function

Anti-T3 Autoantibody
Anti-T4 Autoantibody
Anti-TSH Autoantibody
Antithyroglobulin Antibody
Antithyroid Microsomal Antibody
Antithyroid Peroxidase Antibody (Anti-TPO)
Calcitonin
CSI (Collagen Stimulating Immunoglobulin, TEI, Thyroid Exophthalmic Immunoglobulin)
Somatostatin
T3, dialyzable
T3, Free, Non-Dialysis
T3, Free, Tracer dialysis
T3 Reverse
T3, total (Triiodothyronine), RIA
T4 Binding Proteins
T4 Dialyzable
T4, Free by Tracer Dialysis
T4, Free, Non-Dialysis
T4, Total (Thyroxine)
TBG (Thyroxine Binding Globulin)
TBG Assessment (T3 uptake)
TBII (Thyroptropin-Binding Inhibitory Immunoglobulin)
TGI (Thyroid Growth Stimulating Immunoglobulin)
Thyroglobulin*
Thyrotropin Blocking Antibody
Thyrotropin Releasing Hormone
TSH, 3rd Generation
TSH, Highly Sensitive (HS-TSH)
TSI (Thyroid Stimulating Immunoglobulin)

Urinary Steroid Metabolites by GC/MS

a and B-Cortol
a and B-Cortolone
11B-Hydroxyandrosterone
11B-Hydroxyetiocholoanolone
11-Oxo-etiocholanolone
11-Oxo-pregnanetriol
16a-HydroxyDHEA
17-Hydroxypregnenolone
18-Hydroxycortisol
18-Hydroxytetrahydro-11-dehydrocorticosterone
18-HydroxytetrahydroDOC
18-Oxocortisol
20a and 20B-Dihydrocortisol
5a-Tetrahydrocorticosterone
5a-Tetrahydrocortisol
5-Androstene 3B, 16a, 17B-triol
5-Androstene-3B,17B-diol
5-Pregnene-3B,17a, 20a-triol
6B-Hydroxycortisol
6a-Hydroxytetrahydro-11-dehydrocorticosterone
Androstanediol
Androsterone
Cortisol
Dehydroepiandrosterone
Estradiol
Estriol
Estrone
Etiocholanolone
Pregnanediol
Pregnanetriol
Tetrahydro-11-dehydrocorticosterone
Tetrahydroaldosterone
Tetrahydrocorticosterone
Tetrahydrocortisol
Tetrahydrocortisone
TetrahydroDOC
Tetrahydrosubstance S

Diagnostic Profiles

17a-Hydroxylase Deficiency Profile (GC/MS)
21-Hydroxylase and 11-Hydroxylase Deficiency Profile (GC/MS)
3B-Hydroxysteroid Dehydrogenase Deficiency Profile (GC/MS)
5a-Reductase Deficiency Profile (GC/MS)
Apparent Mineralocorticord Excess Syndrome Profile (GC/MS)
Andrology Panel 1
Andrology Panel 2
Comprehensive Urine Steroid Profile (GC/MS)
Hypoaldosteronism Deficiency Profile (GC/MS)
Mineralcorticoid Profile (GC/MS)
Placental Sulfatase Deficiency Profile (GC/MS)

Congenital Adrenal Hyperplasia Panels

17a-Hydroxylase Deficiency in Females
21-Hydroxylase Deficiency, Severe
21-Hydroxylase, 11-Hydroxylase Deficiencies
3B-Hydroxysteroid Dehydrogenase Deficiency
Aldosterone Synthase Deficiency
Side Chain Cleavage Deficiency
Steroid Replacement Therapy

Perturbation Tests

11-Deoxycortisol (Compound S) Response
17-Hydroxypregnenolone Response, Serum
17-Hydroxyprogesterone Response, Serumv ACTH Petrosal RIA (Series)
Aldosterone Response (ACTH) Serum
C-Peptide Stimulation by Glucagon
Calcitonin Series (Response)
Chromogranin A Stimulation Series
Cortisol Response, Serum
DHEA Response, Serum
Gastrin Secretin Proactive Series
Growth Hormone Response (Suppression or Stimulation)
LG-3rd Generation Series (Response)
Pancreatic Polypeptide Series (Response)
Progesterone Series (Response)