scholarly journals Circulating levels and prognostic value of soluble ST2 in heart failure are less influenced by age than N‐terminal pro‐B‐type natriuretic peptide and high‐sensitivity troponin T

2020 ◽  
Vol 22 (11) ◽  
pp. 2078-2088 ◽  
Author(s):  
Alberto Aimo ◽  
James L. Januzzi ◽  
Giuseppe Vergaro ◽  
A. Mark Richards ◽  
Carolyn S.P. Lam ◽  
...  
2021 ◽  
Vol 10 (21) ◽  
pp. 4868
Author(s):  
Silvia Oghina ◽  
Constant Josse ◽  
Mélanie Bézard ◽  
Mounira Kharoubi ◽  
Marc-Antoine Delbarre ◽  
...  

Background: We assesse the evolution and prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (cTnT-HS) in transthyretin amyloid cardiomyopathy (ATTR-CA) before and after tafamidis treatment. Methods and Results: 454 ATTR-CA patients without tafamidis (Cohort A) and 248 ATTR-CA with tafamidis (Cohort B) were enrolled. Event-free survival (EFS) events were death, heart transplant, or acute heart failure. In Cohort A, 27% of patients maintained NT-proBNP < 3000 ng/L and 14% cTnT-HS < 50 ng/L at 12 months relative to baseline levels. In Cohort B, the proportions were 49% and 29%, respectively. In Cohort A, among the 333 patients without an increased NT-proBNP > 50% relative to baseline EFS was extended compared to the 121 patients with an increased NT-proBNP > 50% (HR: 0.75 [0.57; 0.98]; p = 0.032). In Cohort A, baseline NT-proBNP > 3000 ng/L and cTnT-HS > 50 ng/L and a relative increase of NT-proBNP > 50% during follow-up were independent prognostic factors of EFS. The slopes of logs NT-proBNP and cTnT-HS increased with time before and stabilized after tafamidis. Conclusion: ATTR-CA patients with increasing NT-proBNP had an increased risk of EFS. Tafamidis stabilize NT-proBNP and cTnT-HS increasing, even if initial NT-proBNP levels were >3000 ng/L. Thus suggesting that all patients, irrespective of baseline NT-proBNP levels, may benefit from tafamidis.


2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Francesco Gentile ◽  
Alberto Aimo ◽  
James Lj Jannuzzi ◽  
Mark Richards ◽  
Carolyn Sp Lam ◽  
...  

Abstract Aims Limited evidence exists on sex-related differences in clinical value of biomarkers in chronic heart failure (HF). We aimed to define plasma levels, determinants, and optimal prognostic cut-offs of soluble suppression of tumourigenesis-2 (sST2), high-sensitivity troponin T (hs-TnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in female and male chronic HF patients. Methods and results Individual data of patients from the BIOS (Biomarkers In Heart Failure Outpatient Study) Consortium with sST2, hs-TnT, and NT-proBNP measured were analysed. The primary endpoint was a composite of 1-year cardiovascular death and HF hospitalization. The secondary endpoints were 5-year cardiovascular and all-cause death. The cohort included 4540 patients (age: 67 ± 12 years, LVEF 33 ± 13%, 1111 women, 25%). Women showed lower sST2 (24 vs. 27 ng/ml, P &lt; 0.001) and hs-TnT level (15 vs. 20 ng/l, P &lt; 0.001), and similar concentrations of NT-proBNP (1540 vs. 1505 ng/l, P = 0.408). Although the three biomarkers were confirmed as independent predictors of outcome in both sexes, the optimal prognostic cut-off was lower in women for sST2 (28 vs. 31 ng/ml) and hs-TnT (22 vs. 25 ng/l), while NT-proBNP cut-off was higher in women (2339 ng/l vs. 2145 ng/l). The use of sex-specific cut-offs improved risk prediction compared to the use of previously standardized prognostic cut-offs (Figure). Conclusions In patients with chronic HF, levels of sST2 and hs-TnT, but not of NT-proBNP are lower in women. Lower sST2 and hs-TnT and higher NT-proBNP cut-offs for risk stratification could be used in women.


Circulation ◽  
2018 ◽  
Vol 137 (3) ◽  
pp. 286-297 ◽  
Author(s):  
Alberto Aimo ◽  
James L. Januzzi ◽  
Giuseppe Vergaro ◽  
Andrea Ripoli ◽  
Roberto Latini ◽  
...  

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yashashwi Pokharel ◽  
Wensheng Sun ◽  
Dennis Villarael ◽  
Elizabeth Selvin ◽  
Salim Virani ◽  
...  

Background: Metabolic syndrome (MS) is associated with higher CVD risk. High sensitivity troponin T (hsTnT) is a marker of myocardial injury and an emerging marker for heart failure (HF) risk prediction. We examined whether hsTnT is associated with increased HF risk in people with similar number of MS components present at baseline in 10316 ARIC participants without prevalent HF. Methods: We used Wald Chi-square test to assess the interaction between MS and hsTnT and Cox model for the association of incident HF hospitalization by hsTnT categories across groups created by the number of MS components after adjusting for risk factors and NT-proBNP (Table). Results: The mean age of the study population was 63 (SD, 6) years (56% women). Mean hsTnT levels were higher with increasing MS components (Table). There were 1353 HF hospitalizations over a median of 14 years. The interaction of MS with hsTnT for HF was borderline significant (p-interaction 0.059). Compared to individuals without MS and hsTnT<5 ng/L the HRs (95%CIs) were 1.7 (1.4-2.1) in those without MS and hsTnT≥5 ng/L; 1.7 (1.3-2.1) in MS and hsTnT<5 ng/L; and 3.6 (3.0-4.4) in MS and hsTnT≥5 ng/L. In groups with 1-5 MS components present, increasing hsTnT was significantly associated with higher hazards for HF in each group with the highest HR in those with all 5 MS components (Table). Conclusion: Presence of higher MS risk components was associated with increasing subclinical myocardial injury as assessed by higher hsTnT. The hazards for HF were numerically similar in individuals without MS but detectable hsTnT (>5 ng/L) as to those with MS but undetectable hsTnT. In people with similar number of MS components higher hsTnT levels were associated with increased HF hazards suggesting that in MS hsTnT could be a useful marker for identifying those at higher risk for incident HF.


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