Head-to-head comparison of serial soluble ST2, growth differentiation factor-15, and highly-sensitive troponin T measurements in patients with chronic heart failure.

Gaggin HK, Szymonifka J, Bhardwaj A, Belcher A, De Berardinis B, Motiwala S, Wang TJ, Januzzi JL
JACC Heart Fail. 2014 2 (1): 65-72

PMID: 24622120 · DOI:10.1016/j.jchf.2013.10.005

OBJECTIVES - This analysis aimed to perform a head-to-head comparison of 3 of the promising biomarkers of cardiovascular (CV) outcomes in heart failure (HF)-soluble ST2 (sST2), growth differentiation factor (GDF)-15, and highly-sensitive troponin T (hsTnT)-and to evaluate the role of serial measurement of these biomarkers in patients with chronic HF.

BACKGROUND - sST2, GDF-15, and hsTnT are strongly associated with CV outcomes in HF.

METHODS - This post-hoc analysis used data from a study in which 151 patients with chronic HF due to left ventricular systolic dysfunction were followed up over 10 months. At each visit, N-terminal pro-B-type natriuretic peptide (NT-proBNP), sST2, GDF-15, and hsTnT were measured and any major CV events were recorded.

RESULTS - Baseline values of all 3 novel biomarkers independently predicted total CV events even after adjusting for clinical and biochemical characteristics, including NT-proBNP, with the best model including all 3 biomarkers (p < 0.001). Adding serial measurement to the base model appeared to improve the model's predictive ability (with sST2 showing the most promise), but it is not clear whether this addition is a unique contribution. However, when time-dependent factors were included, only sST2 serial measurement independently added to the risk model (odds ratio: 3.64; 95% confidence interval: 1.37 to 9.67; p = 0.009) and predicted reverse myocardial remodeling (odds ratio: 1.22; 95% confidence interval: 1.04 to 1.43; p = 0.01).

CONCLUSIONS - In patients with chronic HF, baseline measurement of novel biomarkers added independent prognostic information to clinical variables and NT-proBNP. Only serial measurement of sST2 appeared to add prognostic information to baseline concentrations and predicted change in left ventricular function. (Use of NT-proBNP Testing to Guide Heart Failure Therapy in the Outpatient Setting (PROTECT)]; NCT00351390).

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

MeSH Terms (20)

Aged Biomarkers Cardiovascular Diseases Chronic Disease Female Growth Differentiation Factor 15 Heart Failure Humans Interleukin-1 Receptor-Like 1 Protein Male Middle Aged Natriuretic Peptide, Brain Peptide Fragments Prospective Studies Receptors, Cell Surface Risk Assessment Treatment Outcome Troponin T Ventricular Dysfunction, Left Ventricular Remodeling

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