{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T15:03:17Z","timestamp":1763910197855},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T00:00:00Z","timestamp":1536624000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Transfusion\u2010associated circulatory overload (TACO) is a leading cause of serious reactions. In regard to TACO, little is known regarding biomarkers as a predictor, their most informative timing, or thresholds of significance or differentiation from other reactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>In this study of inpatients at risk for TACO (age \u2265 50 years) receiving 1 red blood cell unit, cardiac biomarkers, brain natriuretic peptide (BNP), N\u2010terminal pro\u2010BNP (NT\u2010proBNP), and high\u2010sensitivity troponin were measured at baseline, 6 to 12 hours (except troponin) posttransfusion, and 18 to 24 hours posttransfusion. Primary outcome was a critical increase in biomarkers (&gt;1.5\u2010fold increase and supranormal) at 18 to 24 hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Fifty\u2010one patients were analyzed; 29% had cardiovascular disease, 73% had one or more cardiac risk factors, and 50% took cardiac or antihypertensive therapies. Although eight (16%) developed an increase in systolic pressure of at least 30 mmHg and four (8%) reported dyspnea and\/or cough, none had TACO. At baseline, BNP level was more than 100 ng\/L in 59% and NT\u2010proBNP was more than 300 pg\/mL in 83%. A total of 25% had a BNP critical increase, 33% had a NT\u2010proBNP critical increase, and 2% had a troponin critical increase at 18 to 24 hours. Overall, 38% had at least one biomarker critical increase and NT\u2010proBNP\/BNP concordance was 84%. An increase in the NT\u2010proBNP (&gt;1.5\u2010fold increase and &gt;300 pg\/mL) at 18 to 24 hours was the commonest biomarker change.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>An increase of the NT\u2010proBNP at 18 to 24 hours may be the preferred surrogate marker for identifying a patient experiencing physiologic difficulty in handling the volume challenge. Larger studies are needed to clarify the risk of TACO for a given pretransfusion biomarker profile and the correlation between TACO and increase in biomarkers after transfusion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14820","type":"journal-article","created":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T21:29:19Z","timestamp":1536701359000},"page":"2139-2148","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cardiac stress biomarkers after red blood cell transfusion in patients at risk for transfusion\u2010associated circulatory overload: a prospective observational study"],"prefix":"10.1111","volume":"58","author":[{"given":"Jeannie L.","family":"Callum","sequence":"first","affiliation":[{"name":"Laboratory Medicine and Pathobiology, University of Toronto Toronto Ontario Canada"},{"name":"Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Cohen","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex M.","family":"Cressman","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Strauss","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Armali","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yulia","family":"Lin","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathobiology, University of Toronto Toronto Ontario Canada"},{"name":"Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Pendergrast","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathobiology, University of Toronto Toronto Ontario Canada"},{"name":"University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lani","family":"Lieberman","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathobiology, University of Toronto Toronto Ontario Canada"},{"name":"University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damon C.","family":"Scales","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre Toronto Ontario Canada"},{"name":"Department of Critical Care, Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Skeate","sequence":"additional","affiliation":[{"name":"Canadian Blood Services Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Ross","sequence":"additional","affiliation":[{"name":"Ted Rogers Centre of Excellence in Heart Function University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Cserti\u2010Gazdewich","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathobiology, University of Toronto Toronto Ontario Canada"},{"name":"University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2013.02.001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000513"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03247.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12234"},{"key":"e_1_2_8_6_1","unstructured":"2016 annual SHOT report [Internet]. 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