• DOI:10.1042/CS20120058
• Corpus ID: 25257938

The novel marker LTBP2 predicts all-cause and pulmonary death in patients with acute dyspnoea.

@article{Breidthardt2012TheNM,
  title={The novel marker LTBP2 predicts all-cause and pulmonary death in patients with acute dyspnoea.},
  author={Tobias Breidthardt and Griet Vanpoucke and Mihael Potocki and Tamina Mosimann and Ronny Ziller and Gregoire Thomas and Wouter Laroy and Piet Moerman and Thenral Socrates and Beatrice Drexler and Alexandre Mebazaa and Koen Kas and Christian Mueller},
  journal={Clinical science},
  year={2012},
  volume={123 9},
  pages={
          557-66
        }
}

• T. Breidthardt, G. Vanpoucke, +10 authors C. Mueller
• Published 1 November 2012
• Medicine, Biology
• Clinical science

The risk stratification in patients presenting with acute dyspnoea remains a challenge. We therefore conducted a prospective, observational cohort study enrolling 292 patients presenting to the emergency department with acute dyspnoea. A proteomic approach for antibody-free targeted protein quantification based on high-end MS was used to measure LTBP2 [latent TGF (transforming growth factor)-binding protein 2] levels. Final diagnosis and death during follow-up were adjudicated blinded to LTBP2 levels. AHF (acute heart failure) was the final diagnosis in 54% of patients. In both AHF (P<0.001) and non-AHF (P=0.015) patients, LTBP2 levels at presentation were significantly higher in non-survivors compared with survivors with differences on median levels being 2.2- and 1.5-fold respectively. When assessing the cause of death, LTBP2 levels were significantly higher in patients dying from pulmonary causes (P=0.0005). Overall, LTBP2 powerfully predicted early pulmonary death {AUC (area under the curve), 0.95 [95% CI (confidence interval), 0.91-0.98]}. In ROC (receiver operating characteristic) curve analyses for the prediction of 1-year mortality LTBP2 achieved an AUC of 0.77 (95% CI, 0.71-0.84); comparable with the predictive potential of NT-proBNP [N-terminal pro-B-type natriuruetic peptide; 0.77 (95% CI, 0.72-0.82)]. Importantly, the predictive potential of LTBP2 persisted in patients with AHF as the cause of dypnea (AUC 0.78) and was independent of renal dysfunction (AUC 0.77). In a multivariate Cox regression analysis, LTBP2 was the strongest independent predictor of death [HR (hazard ratio), 3.76 (95% CI, 2.13-6.64); P<0.0001]. In conclusion, plasma levels of LTBP2 present a novel and powerful predictor of all-cause mortality, and particularly pulmonary death. Cause-specific prediction of death would enable targeted prevention, e.g. with pre-emptive antibiotic therapy.