Prospective validation of N‐terminal pro B‐type natriuretic peptide cut‐off concentrations for the diagnosis of acute heart failure

Kozhuharov, Nikola; Sabti, Zaid; Wussler, Desiree; Nowak, Albina; Badertscher, Patrick; Twerenbold, Raphael; Wildi, Karin; Stallone, Fabio; Vogt, F.M.; Hilti, Jonas; Puelacher, Christian; Lavallaz, Jeanne du Fay de; Shrestha, Samyut; Flores, Dayana; Nestelberger, Thomas; Koechlin, Luca; Boeddinghaus, Jasper; Zimmermann, Tobias; Walter, Joan; Schumacher, Carmela; Rentsch, Katharina; Eckardstein, Arnold von; Keller, Dagmar I.; Goudev, Assen; Pfister, Otmar; Breidthardt, Tobias

doi:10.1002/ejhf.1471

Cited by 13 publications

(23 citation statements)

References 8 publications

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“…Cardiac biomarkers are positively associated with the pathophysiology of HF, allowing them to be applied to track disease severity and progression and determine appropriate therapy ( 8 ). Currently, two clinically accessible makers, high sensitivity troponin T and N-terminal pro-B-type natriuretic peptide (NT-proBNP), contribute significantly to the diagnosis and prognosis of HF ( 9 – 12 ). Unfortunately, unlike in HFrEF, the value of these two markers in individuals with HFpEF may be restricted ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical Implications of Plasma Galectin-3 in Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Shi¹,

Dong

Liu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundHeart failure with preserved ejection fraction (HFpEF) is an increasing public health concern. Currently, data regarding the clinical application value of plasma Galectin-3 (Gal-3) in HFpEF are contradictory. Therefore, we performed the following meta-analysis to appraise the clinical implications of serum Gal-3 in HFpEF, including its capacity to predict new-onset disease, long-term unfavorable endpoints, and the degree of cardiac structural abnormality and left ventricular diastolic dysfunction (LVDD).MethodsPubMed, Embase, Scopus, and Web of Science were retrieved exhaustively from their inception until November 30, 2021, to obtain studies assessing the correlation between plasma Gal-3 and the clinical features of HFpEF (new-onset HFpEF, adverse outcomes, and echocardiographic parameters related to abnormal cardiac structure and LVDD).ResultsA total of 24 papers containing 27 studies were ultimately included in the present research. The results of the meta-analysis revealed that high plasma Gal-3 levels are strongly associated with the following clinical characteristics of HFpEF: (i) the increased risk of new-onset HFpEF (HR: 1.11; 95% CI: 1.04-1.19; p = 0.910, I2 = 0%; P = 0.002); (ii) the high risk of adverse outcomes of HFpEF patients [all-cause death (HR: 1.55; 95% CI: 1.27-1.87; p = 0.138, I2 = 42%; P = 0.000) and the composite events [all-cause death and HF hospitalization (HR: 1.50; 95% CI: 1.30-1.74; p = 0.001, I2 = 61%; P = 0.000) or cardiovascular (CV) death and HF hospitalization (HR: 1.71; 95% CI: 1.51-1.94; p = 0.036, I2 = 58%; P = 0.000)]; (iii) echocardiographic indices [E/e ratio (r: 0.425, 95% CI: 0.184-0.617; p = 0.000, I2 = 93%; P = 0.001) and DT (r: 0.502, 95% CI: 0.061-0.779; p = 0.001 I2 = 91%; P = 0.027)].ConclusionsPlasma Gal-3 might be employed as an additional predictor for new-onset HFpEF, the adverse prognosis in HFpEF patients (all-cause death, the composite endpoints of all-cause death and HF hospitalization or CV death and HF hospitalization), and the severity of LVDD in HFpEF populations.

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Section: Introductionmentioning

confidence: 99%

Clinical Implications of Plasma Galectin-3 in Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Shi¹,

Dong

Liu

et al. 2022

Front. Cardiovasc. Med.

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“…However, comparisons between the results of the two studies should be assessed with caution, mainly since the aetiology of AHF in children with a mean age < 2 years in this study substantially differed when compared to the elderly adult AHF population as in our study. BASEL V has important methodological strengths including its large sample size, highly representative elderly patient population for acute dyspnoea and AHF, 18,19 and adjudicated final diagnosis by two independent cardiologists/internists according to current guidelines 1,2…”

Section: Discussionmentioning

confidence: 99%

“…Basics in Acute Shortness of Breath EvaLuation (BASEL V ) was a prospective, multicentre diagnostic study aimed at contributing to advancing the early detection and management of patients with AHF (ClinicalTrials.gov, NCT01831115) 18,19 . Adult patients presenting with acute dyspnoea to the ED of two university hospitals and three further tertiary care centres in Switzerland were enrolled (Basel, Zurich, Lucerne, St. Gallen, and Aarau).…”

Section: Methodsmentioning

confidence: 99%

Cardiac myosin‐binding protein C in the diagnosis and risk stratification of acute heart failure

Kozhuharov

Wussler

Kaier

et al. 2021

European J of Heart Fail

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Aims Cardiac myosin‐binding protein C (cMyC) seems to be even more sensitive in the quantification of cardiomyocyte injury vs. high‐sensitivity cardiac troponin, and may therefore have diagnostic and prognostic utility. Methods and results In a prospective multicentre diagnostic study, cMyC, high‐sensitivity cardiac troponin T (hs‐cTnT), and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) plasma concentrations were measured in blinded fashion in patients presenting to the emergency department with acute dyspnoea. Two independent cardiologists centrally adjudicated the final diagnosis. Diagnostic accuracy for acute heart failure (AHF) was quantified by the area under the receiver operating characteristic curve (AUC). All‐cause mortality within 360 days was the prognostic endpoint. Among 1083 patients eligible for diagnostic analysis, 51% had AHF. cMyC concentrations at presentation were higher among AHF patients vs. patients with other final diagnoses [72 (interquartile range, IQR 39–156) vs. 22 ng/L (IQR 12–42), P < 0.001)]. cMyC's AUC was high [0.81, 95% confidence interval (CI) 0.78–0.83], higher than hs‐cTnT's (0.79, 95% CI 0.76–0.82, P = 0.081) and lower than NT‐proBNP's (0.91, 95% CI 0.89–0.93, P < 0.001). Among 794 AHF patients eligible for prognostic analysis, 28% died within 360 days; cMyC plasma concentrations above the median indicated increased risk of death (hazard ratio 2.19, 95% CI 1.66–2.89; P < 0.001). cMyC's prognostic accuracy was comparable with NT‐proBNP's and hs‐cTnT's. cMyC did not independently predict all‐cause mortality when used in validated multivariable regression models. In novel multivariable regression models including medication, age, left ventricular ejection fraction, and discharge creatinine, cMyC remained an independent predictor of death and had no interactions with medical therapies at discharge. Conclusion Cardiac myosin‐binding protein C may aid physicians in the rapid triage of patients with suspected AHF.

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“…These cut‐offs remain equally useful in AHF across the full spectrum of left ventricular ejection fraction. More recently, the ICON RELOADED (ICON: Re‐evaluation of Acute Diagnostic Cut‐Offs in the Emergency Department) 10 and BASEL‐V 11 studies validated the age‐specific NT‐proBNP cut‐offs in contemporary cohorts. They found that the NT‐proBNP‐supported strategy led to 14.5% fewer initial hospitalizations, 16.0% fewer admissions to cardiology, 12.5% fewer admissions to intensive care units, 3.2% fewer emergency department readmissions, and 21.6% fewer hospital readmissions 12 ( Figure ).…”

Section: What Does the Science Say?mentioning

confidence: 99%

The ‘Peptide for Life’ Initiative: a call for action to provide equal access to the use of natriuretic peptides in the diagnosis of acute heart failure across Europe

Bayés‐Genís

Januzzi

Richards

et al. 2021

European J of Heart Fail

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Prospective validation of N‐terminal pro B‐type natriuretic peptide cut‐off concentrations for the diagnosis of acute heart failure

Cited by 13 publications

References 8 publications

Clinical Implications of Plasma Galectin-3 in Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Clinical Implications of Plasma Galectin-3 in Heart Failure With Preserved Ejection Fraction: A Meta-Analysis

Cardiac myosin‐binding protein C in the diagnosis and risk stratification of acute heart failure

The ‘Peptide for Life’ Initiative: a call for action to provide equal access to the use of natriuretic peptides in the diagnosis of acute heart failure across Europe

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