Comparison of Multiple Biomarkers for Mortality Prediction in Patients with Acute Heart Failure of Ischemic and Nonischemic Etiology

Zhang, Mingliang; Meng, Qingmin; Qi, Xinyan; Han, Qinfeng; Qi, Ximei; Fan, Wei; Du, Beibei

doi:10.2217/bmm-2018-0123

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…По другим данным качество модели прогноза на основе sST2 (по AUC) при ИМ было ниже, чем на основе NT-proBNP [10,12]. Однако в большинстве работ на эту тему значимость sST2 для прогноза неблагоприятных исходов ОСН не зависела от NT-proBNP и не снижалась при включении обоих биомаркеров в модель при увеличении ее точности [13,14], что явилось обоснованием концепции мультимаркерных систем стратификации риска, в т.ч. при ИМпST [8,12].…”

Section: Discussionunclassified

Role of soluble ST2 in short-term prediction of acute heart failure in acute ST-elevation myocardial infarction

et al. 2021

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Aim. To investigate the relationship of soluble ST2 (sST2) to acute heart failure (AHF) and compare the predictive value of sST2 and brain natriuretic peptide in patients with ST-elevation myocardial infarction (STEMI).Material and methods. In 136 STEMI patients, the serum sST2 concentration was determined during the first 24 hours of hospitalization. We assessed levels of sST2, N-terminal pro-brain natriuretic peptide (NT-proBNP), incidence of Killip class II-IV AHF during hospitalization, myocardial necrosis biomarkers, parameters of complete blood count and biochemical blood tests, the incidence of cardiovascular diseases and risk factors. The predictive value of sST2 for AHF development was assessed using logistic regression. ROC analysis was performed. The areas under the ROC curve were compared for sST2 and NT-proBNP. The cut-off sST2 value was determined for predicting AHF.Results. The mean sST2 level was 43,4 (33,6-73,9) ng/ml. During the followup period, AHF was diagnosed in 54 people (39,7%). The prevalence of AHF in the 1st, 2nd and 3rd tertiles of sST2 was 15,6%, 33,3% and 69,7%, respectively. The NT-proBNP levels were 319 (128-1072) pg/ml, 430 (147-1140) pg/ml and 1317 (533-2386) pg/ml. The predictive value of 3rd sST2 tertile was retained adjusted for age, sex, NT-proBNP, troponin T, creatine phosphokinase-MB, high-sensitivity C-reactive protein, hemoglobin, blood glucose, left ventricular ejection fraction. The areas under the ROC curves for sST2 and NT-proBNP were comparable (0,828 and 0,733, respectively; p=0,056). The cut-off sST2 value was 64 ng/ml, above which the odds ratio of AHF was 11,1 (95% confidence interval, 4,7-26,1.Conclusion. An increase in blood sST2 is associated with an increase in AHF (Killip II-IV) prevalence in hospitalized patients with acute STEMI. Soluble ST2 has an independent predictive value for AHF in STEMI, comparable in strength and predictive model quality to NT-proBNP. The cut-off sST2 value for AHF (>64 ng/ ml) was calculated, which provides an optimal balance of sensitivity, specificity and accuracy of the prognostic model. These data support the potential value of sST2 as a biomarker of AHF in STEMI.

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Section: Discussionunclassified

Role of soluble ST2 in short-term prediction of acute heart failure in acute ST-elevation myocardial infarction

et al. 2021

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“…Eight studies [Clementy 2018;de Boer 2011;Carrasco-Sanchez 2013;Beltrami 2016;van Vark 2017;Lala 2018;Testa 2018;Zhang 2018] evaluated the relationship between galectin-3 and all-cause mortality of AHF, in which encountered 642 (22.0%) death out of 2915 AHF patients. Using the random-effects model, the result indicated that for every 1% increase in plasma galactosin-3, the associated risk of allcause mortality increased by 117% (HR 2.17, 95% CI 1.27-3.08, I 2 = 90.7%).…”

Section: Literature Searchmentioning

confidence: 99%

Galectin-3 in Predicting Mortality of Heart Failure: A Systematic Review and Meta-Analysis

Zhou

et al. 2021

HSF

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Background: In recent years, galectin-3, an inflammatory marker, has been demonstrated to be closely related to cardiac fibrosis and heart failure. The purpose of this systematic review and meta-analysis is to define galectin-3 in predicting mortality of heart failure. Methods: PubMed, Embase, and the Cochrane Library were searched. A total of 1540 studies were identified, and of these studies, 19 involving 9217 patients were included in our meta-analysis. Results: The diagnostic hazard ratios of galectin-3 in predicting mortality in chronic heart failure patients was 1.13 (95% CI,:1.07-1.21 ) and 2.17 (95% CI:1.27-3.08) in acute heart failure (HF) patients. Conclusions: Our meta-analysis shows that elevated levels of galectin-3 are associated with higher mortality in both acute and chronic heart failure patients.

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“…There is no strong evidence that single biomarker use is superior to a multiple biomarker strategy for every clinical condition in HF patients. For instance, the MOLI-TOR (Impact of Therapy Optimisation on the Level of Biomarkers in Patients with Acute and Decompensated Chronic Heart Failure) study has shown that serial measurements of multiple biomarkers (C-terminal fragment of pre-pro-vasopressin, NT-proBNP, midregional pro-atrial natriuretic peptide, mid-regional pro-adrenomedullin, and C-terminal pro-endothelin-1) in advanced HF were no better than measurements of the C-terminal fragment of pre-pro-vasopressin [157]. Pandey A. et al (2021) [158] evaluated the application of a biomarker-based risk score to identify patients with dysglycemia that were at high risk of incident HF.…”

Section: Multiple Biomarker Strategiesmentioning

confidence: 99%

Heart Failure and Diabetes Mellitus: Biomarkers in Risk Stratification and Prognostication

et al. 2021

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Heart failure (HF) and type 2 diabetes mellitus (T2DM) have a synergistic effect on cardiovascular (CV) morbidity and mortality in patients with established CV disease (CVD). The aim of this review is to summarize the knowledge regarding the discriminative abilities of conventional and novel biomarkers in T2DM patients with established HF or at higher risk of developing HF. While conventional biomarkers, such as natriuretic peptides and high-sensitivity troponins demonstrate high predictive ability in HF with reduced ejection fraction (HFrEF), this is not the case for HF with preserved ejection fraction (HFpEF). HFpEF is a heterogeneous disease with a high variability of CVD and conventional risk factors including T2DM, hypertension, renal disease, older age, and female sex; therefore, the extrapolation of predictive abilities of traditional biomarkers on this population is constrained. New biomarker-based approaches are disputed to be sufficient for improving risk stratification and the prediction of poor clinical outcomes in patients with HFpEF. Novel biomarkers of biomechanical stress, fibrosis, inflammation, oxidative stress, and collagen turn-over have shown potential benefits in determining prognosis in T2DM patients with HF regardless of natriuretic peptides, but their role in point-to-care and in routine practice requires elucidation in large clinical trials.

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Comparison of Multiple Biomarkers for Mortality Prediction in Patients with Acute Heart Failure of Ischemic and Nonischemic Etiology

Cited by 7 publications

References 25 publications

Role of soluble ST2 in short-term prediction of acute heart failure in acute ST-elevation myocardial infarction

Role of soluble ST2 in short-term prediction of acute heart failure in acute ST-elevation myocardial infarction

Galectin-3 in Predicting Mortality of Heart Failure: A Systematic Review and Meta-Analysis

Heart Failure and Diabetes Mellitus: Biomarkers in Risk Stratification and Prognostication

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