Serial cardiac biomarker assessment in adults with congenital heart disease hospitalized for decompensated heart failure

Aldweib, Nael; Elia, Eleni G.; Brainard, Sarah; Wu, Fred; Sleeper, Lynn A.; Rodriquez, Carla; Valente, Anne Marie; Landzberg, Michael J.; Singh, Michael; Mullen, Mary P.; Opotowsky, Alexander R.

doi:10.1016/j.ijcchd.2022.100336

Cited by 4 publications

(2 citation statements)

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“…Although the biomarker-guided approach to predict the natural evolution of HF and detect vulnerable populations in terms of all-cause mortality, CV death, and HF hospitalization appears promising, there is uncertainty in the optimal number of biomarkers selected in multi-marker scores, economic burden after implementation of the strategy, and impact of biomarker measures on the modification of HF management [93,94]. Preference for genomic, transcriptomic, proteomic, and metabolomic evaluation in comparison with a single biomarker determination is not specified and requires more data for evaluation [95]. In this regard, cell-free and packaged microRNAs, circulating extracellular vesicles, and precursors of various cells (endothelial progenitor cells and mononuclear precursors), which are engaged in cardiac and vascular repair, are regarded as interesting options for future investigations of improving personalization in HF management [96].…”

Section: Future Directionsmentioning

confidence: 99%

Biomarkers in Heart Failure: From Research to Clinical Practice

Berezin

2022

Ann Lab Med

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The aim of this narrative review is to summarize contemporary evidence on the use of circulating cardiac biomarkers of heart failure (HF) and to identify a promising biomarker model for clinical use in personalized point-of-care HF management. We discuss the reported biomarkers of HF classified into clusters, including myocardial stretch and biomechanical stress; cardiac myocyte injury; systemic, adipocyte tissue, and microvascular inflammation; cardiac fibrosis and matrix remodeling; neurohumoral activation and oxidative stress; impaired endothelial function and integrity; and renal and skeletal muscle dysfunction. We focus on the benefits and drawbacks of biomarker-guided assistance in daily clinical management of patients with HF. In addition, we provide clear information on the role of alternative biomarkers and future directions with the aim of improving the predictive ability and reproducibility of multiple biomarker models and advancing genomic, transcriptomic, proteomic, and metabolomic evaluations.

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Section: Future Directionsmentioning

confidence: 99%

Biomarkers in Heart Failure: From Research to Clinical Practice

Berezin

2022

Ann Lab Med

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“…Also, other authors have reported that adults with CHD and elevated CRP not only have a greater risk for death or non-elective cardiovascular hospitalization but also a worse functional status and exercise capacity [8]. Furthermore, serial CRP measurements seem to provide prognosis after hospital discharge, identifying CHD patients at higher risk of re-admission for heart failure [9].…”

Section: Introductionmentioning

confidence: 99%

C-Reactive Protein and Long-Term Prognosis in Adult Patients with Congenital Heart Disease

Martínez-Quintana,

Alcántara-Castellano,

García-Suárez

et al. 2024

JCM

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Background/Objectives: Prognostic biomarkers may provide information about the patient’s cardiovascular outcomes. However, there are doubts regarding how high-sensitivity C-reactive protein (hs-CRP) impacts patients with congenital heart disease (CHD). The main objective is to evaluate whether high hs-CRP levels predict a worse prognosis in patients with CHD. Methods: Observational and prospective cohort study. Adult CHD patients and controls were matched for age and sex. Results: In total, 434 CHD patients (cases) and 820 controls were studied. The median age in the CHD patients was 30 (18–62) years and 256 (59%) were male. A total of 51%, 30%, and 19% of patients with CHD had mild, moderate, and great complexity defects, respectively. The body mass index [1.07 (1.01–1.13), p = 0.022)], diabetes mellitus [3.57 (1.07–11.97), p = 0.039], high NT-pro-BNP levels [1.00 (1.00–1.01), p = 0.021], and low serum iron concentrations [0.98 (0.97–0.99), p = 0.001] predicted high hs-CRP levels (≥0.3 mg/dL) in patients with CHD. During a follow-up time of 6.81 (1.17–10.46) years, major cardiovascular events (MACE) occurred in 40 CHD patients, showing the Kaplan–Meier test demonstrated a worse outcome among patients with hs-CRP levels above 0.3 mg/dL (p = 0.012). Also, hs-CRP showed statistical significance in the univariate Cox regression survival analysis. However, after adjusting for other variables, this significance was lost and the remaining predictors of MACE were age [HR 1.03 (1.01–1.06), p = 0.001], great complexity defects [HR 2.46 (1.07–5.69), p = 0.035], and an NT pro-BNP cutoff value for heart failure > 125 pg/mL [HR 7.73 (2.54–23.5), p < 0.001]. Conclusions: Hs-CRP obtained statistical significance in the univariate survival analysis. However, this significance was lost in the multivariate analysis in favor of age, CHD complexity, and heart failure.

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Editor's corner & issue at a glance

Gatzoulis

2022

International Journal of Cardiology Congenital Heart Disease

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Serial cardiac biomarker assessment in adults with congenital heart disease hospitalized for decompensated heart failure

Cited by 4 publications

References 45 publications

Biomarkers in Heart Failure: From Research to Clinical Practice

Biomarkers in Heart Failure: From Research to Clinical Practice

C-Reactive Protein and Long-Term Prognosis in Adult Patients with Congenital Heart Disease

Editor's corner & issue at a glance

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