Use of serum levels of high sensitivity troponin T, galectin-3 and C-terminal propeptide of type I procollagen at long term follow-up in heart failure patients with reduced ejection fraction: Comparison with soluble AXL and BNP
Por:
Batlle, M, Campos, B, Farrero, M, Cardona, M, Gonzalez, B, Castel, MA, Ortiz, J, Roig, E, Pulgarin, MJ, Ramirez, J, Bedini, JL, Sabate, M, de Frutos, PG, Perez-Villa, F
Publicada:
15 dic 2016
Resumen:
Background: Prognostic biomarkers are needed to improve the management of the heart failure (HF) epidemic, being the brain natriuretic peptides the most valuable. Here we evaluate 3 biomarkers, high sensitivity troponin T (hs-TnT), galectin-3 (Gal-3) and C-terminal propeptide of type I procollagen (CICP), compare them with a recently described new candidate (sAXL), and analyze their relationship with BNP.
Methods: HF patients with reduced ejection fraction (n=192) were included in this prospective observational study, with measurements of candidate biomarkers, functional, clinical and echocardiographic variables. A Cox regression model was used to determine predictors for clinical events, i.e. all-cause mortality and heart transplantation.
Results: Hs-TnT circulating values were correlated to clinical characteristics indicative of more advanced HF. When analyzing the event-free survival at a mean follow-up of 3.6 years, patients in the higher quartile of either BNP, hs-TnT, CICP and sAXL had increased risk of suffering a clinical event, but not Gal-3. Combination of high sAXL and BNP values had greater predictive value (HR 6.8) than high BNP alone (HR 4.9). In a multivariate Cox regression analysis, BNP, sAXL and NYHA class were independent risk factors for clinical events.
Conclusions: In this HF cohort, hs-TnT is a good HF marker and has a very significant prognostic value. The prognostic value of CICP and sAXL was of less significance. However, hs-TnT did not add predictive value to BNP, while sAXL did. This suggests that elevated troponin has a common origin with BNP, while sAXL could represent an independent pathological mechanism. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
Filiaciones:
Batlle, M:
Hosp Clin Barcelona, Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
Hosp Clin Barcelona, Cardiovasc Clin Inst, Barcelona, Spain
Campos, B:
Univ Barcelona, Dept Publ Hlth, E-08007 Barcelona, Spain
Farrero, M:
Hosp Clin Barcelona, Cardiovasc Clin Inst, Heart Failure & Transplant Unit, Barcelona, Spain
Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
Cardona, M:
Hosp Clin Barcelona, Cardiovasc Clin Inst, Heart Failure & Transplant Unit, Barcelona, Spain
Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
Gonzalez, B:
Hosp Clin Barcelona, Core Lab, Barcelona, Spain
Castel, MA:
Hosp Clin Barcelona, Cardiovasc Clin Inst, Heart Failure & Transplant Unit, Barcelona, Spain
Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
Ortiz, J:
Hosp Clin Barcelona, Cardiovasc Clin Inst, Heart Failure & Transplant Unit, Barcelona, Spain
Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
Roig, E:
Univ Autonoma Barcelona, Inst Recerca Biomed IIB St Pau, Hosp Santa Creu & St Pau, Heart Failure Unit,Cardiol Dept, E-08193 Barcelona, Spain
Pulgarin, MJ:
Hosp Clin Barcelona, Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
Hosp Clin Barcelona, Cardiovasc Clin Inst, Barcelona, Spain
Ramirez, J:
Hosp Clin Barcelona, Dept Pathol Anat, Barcelona, Spain
Bedini, JL:
Hosp Clin Barcelona, Core Lab, Barcelona, Spain
Sabate, M:
Hosp Clin Barcelona, Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
Hosp Clin Barcelona, Cardiovasc Clin Inst, Barcelona, Spain
de Frutos, PG:
Inst Invest Biomed Barcelona IIBB CSIC, Dept Cell Death & Proliferat, Barcelona, Spain
IDIBAPS, Barcelona, Spain
Perez-Villa, F:
Hosp Clin Barcelona, Cardiovasc Clin Inst, Heart Failure & Transplant Unit, Barcelona, Spain
Inst Biomed Res August Pi & Sunyer IDIBAPS, Barcelona, Spain
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