Short- and Long-term Biologic Variability of Galectin-3 and Other Cardiac Biomarkers in Patients with Stable Heart Failure and Healthy Adults

Abstract BACKGROUND Galectin-3 (Gal-3) has been suggested as a prognostic biomarker in heart failure (HF) patients that may better reflect disease progression than traditional markers, including B-type natriuretic peptide (BNP) and cardiac troponins. To fully establish the utility of any biomarker in HF, its biologic variability must be characterized. METHODS To assess biologic variability, 59 patients were prospectively recruited, including 23 male and 16 female patients with stable HF and 10 male and 10 female healthy individuals. Gal-3, BNP, and high-sensitivity cardiac troponin I (hs-cTnI) were assayed at 5 time points within a 3-week period to assess short-term biologic variability. Long-term (3-month) biologic variability was assessed with samples collected at enrollment and after 4, 8, and 12 weeks. RESULTS Among healthy individuals, mean short-term biologic variability, expressed as intraindividual CV (CVI), was 4.5% for Gal-3, 29.0% for BNP, and 14.5% for hs-cTnI; long-term biologic variability was 5.5% for Gal-3, 34.7% for BNP, and 14.7% for hs-cTnI. In stable HF patients, mean short-term biologic variability was 7.1% for Gal-3, 22.5% for BNP, and 8.5% for hs-cTnI, and mean long-term biologic variability was 7.7% for Gal-3, 27.6% for BNP, and 9.6% for hs-cTnI. CONCLUSIONS The finding that Gal-3 has minimal intraindividual biological variability adds to its potential as a useful biomarker in HF patients.

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Short- and long-term biological variation of cardiac troponin I in healthy individuals, and patients with end-stage renal failure requiring haemodialysis or cardiomyopathy

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-0046 ◽

2020 ◽

Vol 58 (11) ◽

pp. 1941-1949

Author(s):

Nick S. R. Lan ◽

Lan T. Nguyen ◽

Samuel D. Vasikaran ◽

Catherine Wilson ◽

Jacqueline Jonsson ◽

...

Keyword(s):

Renal Failure ◽

Cardiac Troponin ◽

Troponin I ◽

Biological Variation ◽

Healthy Individuals ◽

Short Term ◽

End Stage Renal Failure ◽

Short And Long Term ◽

End Stage

AbstractObjectivesHigh-sensitivity (hs) cardiac troponin (cTn) assays can quantitate small fluctuations in cTn concentration. Determining biological variation allows calculation of reference change values (RCV), to define significant changes. We assessed the short- and long-term biological variation of cardiac troponin I (cTnI) in healthy individuals and patients with renal failure requiring haemodialysis or cardiomyopathy.MethodsPlasma samples were collected hourly for 4 h and weekly for seven further weeks from 20 healthy individuals, 9 renal failure patients and 20 cardiomyopathy patients. Pre- and post-haemodialysis samples were collected weekly for 7 weeks. Samples were analysed using a hs-cTnI assay (Abbott Alinity ci-series). Within-subject biological variation (CVI), analytical variation (CVA) and between-subject biological variation (CVG) was used to calculate RCVs and index of individuality (II).ResultsFor healthy individuals, CVI, CVA, CVG, RCV and II values were 8.8, 14.0, 43.1, 45.8% and 0.38 respectively for short-term, and 41.4, 14.0, 25.8, 121.0% and 1.69 for long-term. For renal failure patients, these were 2.6, 5.8, 50.5, 17.6% and 0.30 respectively for short-term, and 19.1, 5.8, 11.2, 55.2% and 1.78 for long-term. For cardiomyopathy patients, these were 4.2, 10.0, 65.9, 30.0% and 0.16 respectively for short-term, and 17.5, 10.0, 63.1, 55.8% and 0.32 for long-term. Mean cTnI concentration was lower post-haemodialysis (15.2 vs. 17.8 ng/L, p < 0.0001), with a 16.9% mean relative change.ConclusionsThe biological variation of cTnI is similar between end-stage renal failure and cardiomyopathy patients, but proportionately greater in well-selected healthy individuals with very low baseline cTnI concentrations.

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Crédito consignado: segmentos e efeitos econômicos

RACE - Revista de Administração Contabilidade e Economia ◽

10.18593/race.v17i2.16604 ◽

2018 ◽

Vol 17 (2) ◽

pp. 783-810

Author(s):

Angélica Pott de Medeiros ◽

Giulia Xisto de Oliveira ◽

Reisoli Bender Filho

Keyword(s):

Economic Recession ◽

High Sensitivity ◽

Variance Decomposition ◽

Economic Effects ◽

Short Term ◽

Macroeconomic Variables ◽

The Public ◽

Short And Long Term ◽

Vector Estimation

Resumo: O cenário de instabilidade política, a recessão econômica e as mudanças nas regras de concessão de crédito pautaram o objetivo de examinar o relacionamento do crédito consignado, por segmento de concessão, com variáveis macroeconômicas, caso do consumo, da produção industrial e do produto agregado, na última década (2007-2017). Os resultados foram obtidos por meio da estimação do vetor de correção de erros, funções de impulso-resposta e decomposição da variância, possibilitando a análise das relações de curto e de longo prazo entre as séries temporais e indicaram que as diferentes modalidades do crédito consignado implicam efeitos distintos sobre as variáveis econômicas em curto prazo. O segmento de aposentados e pensionistas impacta positivamente ambas as variáveis analisadas, com destaque para os bens de consumo das famílias. Já a concessão ao setor privado, embora represente a menor parcela do crédito consignado concedido, mostrou elevada sensibilidade a alterações na oferta dessa modalidade de crédito, enquanto que o crédito ao setor público, de maior participação, apresentou efeitos reduzidos e de curta duração.Palavras-chave: Crédito consignado. Segmentos. Economia brasileira. Payroll loans: segments and economic effects Abstract: The environment of political instability, economic recession and changes in the rules of granting credit were guiders to aim to examine the payroll loans relationship, by concession segment, with macroeconomic variables, case of consumption, industrial production and aggregate product, in the last decade (2007-2017). The results obtained by error correction vector estimation, and functions of impulse-response and variance decomposition, making it possible to analyze the short- and long-term relationships between the time series and indicated that the different modalities of payroll loans imply different effects on economic short-term variables. With retirees and pensioners segment positively impact on both analyzed variables, highlighting the household consumption goods. The concession to the private sector, although it represents the smallest portion of payroll loans granted, it showed high sensitivity to the changes of this modality. About credit to the public sector, which has the biggest portion, it showed reduced and short-term effects.Keywords: Payroll loans. Segments. Brazilian economy.

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Short- and Long-Term Biological Variation in Cardiac Troponin I Measured with a High-Sensitivity Assay: Implications for Clinical Practice

Clinical Chemistry ◽

10.1373/clinchem.2008.107391 ◽

2009 ◽

Vol 55 (1) ◽

pp. 52-58 ◽

Cited By ~ 180

Author(s):

Alan H B Wu ◽

Quynh Anh Lu ◽

John Todd ◽

Joachim Moecks ◽

Frank Wians

Keyword(s):

Detection Limit ◽

Cardiac Troponin ◽

Troponin I ◽

High Sensitivity ◽

Population Based ◽

Biological Variation ◽

Cardiac Troponin I ◽

Low Concentrations ◽

Short And Long Term

Abstract Background: The improved detection limit and precision in new-generation commercial assays for cardiac troponin I (cTnI) have lowered the 99th-percentile cutoff value, yielding higher frequencies of positive test results. Because serial testing is important in interpreting low concentrations, we evaluated the biological variation of cTnI in both the short (hours) and long (weeks) terms and determined reference change values (RCVs) and the index of individuality (II) for cTnI. Methods: To assess short- and long-term variation, we collected blood from 12 healthy volunteers hourly for 4 h and from 17 healthy individuals once every other week for 8 weeks, measured cTnI with a high-sensitivity assay (detection limit, 0.2 ng/L), and computed analytical, intraindividual, interindividual, and total CVs (CVA, CVI, CVG, and CVT, respectively; CVT = CVA + CVI + CVG) as well as the II. Because of the slight right-skewness of the data, RCVs were calculated with a lognormal approach. Results: Within-day CVA, CVI, and CVG values were 8.3%, 9.7%, and 57%, respectively; the corresponding between-day values were 15%, 14%, and 63%. Within- and between-day IIs were 0.21 and 0.39, respectively. Lognormal within-day RCVs were 46% and −32%, respectively; the corresponding between-day values were 81% and −45%. Conclusions: The low II indicates that population-based reference intervals are less useful for interpreting cTnI values than following serial changes in values in individual patients. This criterion is particularly important for interpreting results from patients who show cTnI increases at low concentrations measured with very high-sensitivity assays, from patients presenting with chest pain (short term), and for evaluating drugs for cardiotoxicity (long term).

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Short- and Long-Term Risk Stratification Using a Next-Generation, High-Sensitivity Research Cardiac Troponin I (hs-cTnI) Assay in an Emergency Department Chest Pain Population

Clinical Chemistry ◽

10.1373/clinchem.2009.127241 ◽

2009 ◽

Vol 55 (10) ◽

pp. 1809-1815 ◽

Cited By ~ 66

Author(s):

Peter A Kavsak ◽

Xuesong Wang ◽

Dennis T Ko ◽

Andrew R MacRae ◽

Allan S Jaffe

Keyword(s):

Emergency Department ◽

Risk Stratification ◽

Cardiac Troponin ◽

Troponin I ◽

High Sensitivity ◽

Next Generation ◽

Roc Curve Analysis ◽

Coronary Syndrome ◽

Short And Long Term

Abstract Background: The next-generation, high-sensitivity cardiac troponin assays can measure quantifiable concentrations of cTn in a majority of individuals, but there are few studies assessing these assays for risk stratification. The present study was undertaken to determine if a research hs-cTnI assay can be useful for predicting death/myocardial infarction (MI), both short- and long-term, in an emergency department acute coronary syndrome (ACS) population. Methods: In a cohort of 383 subjects, originally recruited in 1996, presenting to the emergency department with symptoms suggestive of ACS, the heparin plasma obtained at initial presentation was thawed and measured in 2007 with a research hs-cTnI assay. AccuTnI (Beckman Coulter) measurements were made on these same samples in 2003. The population was divided into 4 groups by hs-cTnI: <5.00, 5.00–9.99, 10.00–40.00, and >40.00 ng/L. Kaplan–Meier, Cox proportional hazards, ROC curves, and logistic regression analyses were used to identify which hs-cTnI concentrations were predictive of death/MI within 10 years after presentation. Results: There were significant differences between the hs-cTnI groups for the probability of death/MI up to 10 years after presentation (P < 0.05). At 6 months, patients with hs-cTnI ≥10.00 ng/L were at higher risk for death/MI (hazard ratio >3.7; P < 0.05) compared with those having hs-cTnI <5.00 ng/L. ROC curve analysis for death/MI at 30 days with the hs-cTnI assay had an area under the curve of 0.74 (95% CI 0.65–0.82), with logistic models yielding an optimal assay threshold of 12.68 ng/L. Conclusions: This research hs-cTnI assay appears useful for risk stratification for death/MI in an ACS population.

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Utility of plasma galectin-3 in predicting long-term mortality in patients with acute heart failure

Biomedical Research and Therapy ◽

10.15419/bmrat.v8i4.669 ◽

2021 ◽

Vol 8 (4) ◽

pp. 4306-4314

Author(s):

Hoang Van Sy ◽

Dang Quang Toan ◽

Ta Thi-Thanh Huong ◽

Chau Ngoc Hoa ◽

Tran Kim Trang

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Troponin I ◽

All Cause Mortality ◽

Galectin 3 ◽

One Year ◽

Time Of Admission ◽

Long Term Mortality

Background: Several studies have investigated Galectin-3 as a promising biomarker for predicting the short-term and long-term mortality of patients with acute heart failure. This study aimed to examine the usefulness of plasma galectin-3 at the time of admission in predicting long-term mortality in Vietnamese patients with acute heart failure (AHF). Methods: We carried out a cohort study including 117 patients consecutively diagnosed with acute heart failure in a single cardiology department. Plasma galectin-3 and other biomarkers were measured at the time of admission. The patient’s clinical and analytical characteristics were recorded. The main endpoint was one-year all-cause mortality. Results: There were six patients (5%) lost to follow-up and 59 patients (53.2%) reaching primary outcome within one year after ‎hospital admission.‎ The median plasma galectin-3 level (ng/mL) in patients with acute heart failure was 34.6 (26.7 – 44.1). Plasma galectin-3 in the alive group was significantly higher than that in the deceased group at one-year follow-up. In predicting one-year all-cause mortality, galectin-3 had an area under the curve (AUC) of 0.71 (95% confidence interval (CI), 0.62 – 0.81) representing a good prognostic factor while brain natriuretic peptide (BNP) and troponin I were inferior to galectin-3 with an AUC of 0.69 (95% CI, 0.59 – 0.79) and 0.63 (95% CI, 0.53 – 0.74), respectively. The optimal cut-off value for galectin-3 was 40.75 ng/mL with a sensitivity of 50.1% and a specificity of 88.5%. In a multivariate model, patients with galectin-3 levels > 40.75 ng/mL had a hazard ratio (HR) of 2.8 (95% CI, 1.5 – 5; p = 0.001). The best prediction model was the combined model of galectin-3 and BNP, yielding an AUC of 0.78 (95% CI, 0.70 – 0.86; p < 0.001). Conclusions: Our study suggested that galectin-3 levels could predict long-term all-cause mortality in patients with acute heart failure with a good prognostic capacity. Combining galectin-3 and BNP could bring up a better risk-stratification.

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The GALA study: relationship between galectin-3 serum levels and short- and long-term outcomes of patients with acute heart failure

Biomarkers ◽

10.1080/1354750x.2017.1319421 ◽

2017 ◽

Vol 22 (8) ◽

pp. 731-739 ◽

Cited By ~ 7

Author(s):

Òscar Miró ◽

Bernardino González de la Presa ◽

Pablo Herrero-Puente ◽

Rosa Fernández Bonifacio ◽

Martin Möckel ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Serum Levels ◽

Long Term Outcomes ◽

Galectin 3 ◽

Short And Long Term

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Biological and Analytical Variability of a Novel High-Sensitivity Cardiac Troponin T Assay

Clinical Chemistry ◽

10.1373/clinchem.2009.140616 ◽

2010 ◽

Vol 56 (7) ◽

pp. 1086-1090 ◽

Cited By ~ 106

Author(s):

Vlad C Vasile ◽

Amy K Saenger ◽

Jean M Kroning ◽

Allan S Jaffe

Keyword(s):

Cardiac Troponin ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Troponin T ◽

Short Term ◽

Term Study ◽

Term Change ◽

Short And Long Term ◽

Log Normal

Abstract Background: High-sensitivity cardiac troponin assays will augment the frequency of increased results, making important the determination of reference change values to distinguish acute from chronic increases. We assessed short- and long-term biological variability of cardiac troponin T (cTnT) in healthy subjects with a novel high-sensitivity (hs) assay. Methods: We collected blood from 20 healthy volunteers at 5 time points for short-term study and biweekly at 4 times from the same volunteers for long-term study. We analyzed serum samples in duplicate with a hscTnT assay on the Roche Modular E170 and computed reference change values (RCVs) for analytical, intraindividual, interindividual, and total change values (CVA, CVI, CVG, and CVT, respectively) and the index of individuality (II). We calculated RCVs by using a log-normal approach, owing to the skewed results of the data. Results: Short- and long-term CVA values were 53.5% and 98%. CVI and CVG were 48.2% and 85.9%, respectively, for short-term studies and 94% and 94% for long-term studies. Mean δ values for the within-day study were 58% and −57.5%, and between-day mean δ values were 103.4% and −87%. Within- and between-day IIs were 0.8 and 0.14, respectively. Conclusions: The biological variation demonstrated with the hscTnT assay is higher than prior data for cardiac troponin I. This may be attributed to differences in biology or assay imprecision at low concentrations. A short-term change (RCV log normal) of 85% and a long-term change of 315% is necessary to define a changing pattern.

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Variability in Cardiac Biomarkers during Hemodialysis: A Prospective Cohort Study

Clinical Chemistry ◽

10.1093/clinchem/hvaa299 ◽

2020 ◽

Author(s):

David Collister ◽

Andrea Mazzetti ◽

Anuja Bhalerao ◽

Jessica Tyrwhitt ◽

Peter Kavsak ◽

...

Keyword(s):

Troponin I ◽

Treatment Time ◽

High Sensitivity ◽

Cardiac Biomarkers ◽

Linear Regression Models ◽

Fatty Acid Binding ◽

Cardiac Biomarker ◽

Hemodialysis Treatment ◽

Galectin 3 ◽

Multilevel Linear Regression

Abstract Background The effect of hemodialysis on cardiac biomarkers is unclear. We sought to evaluate the degree and causes of intradialytic variability of high sensitivity troponin I (hs-TnI), galectin-3 (gal-3), and heart-type fatty acid binding protein (hFABP). Methods hs-TnI, gal-3, and hFABP were prospectively measured pre-dialysis and post-dialysis for 1 week every month for 6 months in 178 prevalent adult hemodialysis patients at a single center in Hamilton, Canada. The degree of change from pre-dialysis to post-dialysis for each cardiac biomarker was estimated with multilevel linear regression models. Results The median change in the concentration of hs-TnI during hemodialysis was −1 ng/L (interquartile range [IQR] −1 to 2 ng/L) while gal-3 and hFABP changed by −36.3 ng/mL (IQR −27.7 to −46.8 ng/mL) and −19.41 ng/mL (IQR −13.61 to −26.87 ng/mL), respectively. The median (IQR) percentage intradialytic changes for hs-TnI, gal-3, and hFABP were 2.6% (−4.4% to 12.5%), −59.8% (−54.7% to −64.8%) and −35.3% (−28.4% to −42.1%), respectively. Ultrafiltration was associated with an increase in concentration of hs-TnI, gal-3, and hFABP (mean 0.99 ng/L, 1.05 ng/mL, and 1.9 ng/mL per L ultrafiltration, respectively, P < 0.001). Both gal-3 and hFABP concentrations decreased in association with the volume of blood processed (P < 0.001) and with hemodialysis treatment time (P = 0.02 and P = 0.04) while hs-TnI concentration decreased only in association with hemodialysis treatment time (P < 0.001). Conclusions Ultrafiltration volume and hemodialysis treatment time influenced hs-TnI, gal-3, and hFABP concentrations during hemodialysis and should be considered when interpreting their measurement.

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Usefulness of Combining Galectin-3 and BIVA Assessments in Predicting Short- and Long-Term Events in Patients Admitted for Acute Heart Failure

BioMed Research International ◽

10.1155/2014/983098 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 11

Author(s):

Benedetta De Berardinis ◽

Laura Magrini ◽

Giorgio Zampini ◽

Benedetta Zancla ◽

Gerardo Salerno ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Cox Regression ◽

Survival Curve ◽

Early Assessment ◽

Cox Regression Analysis ◽

Survival Difference ◽

Galectin 3 ◽

Short And Long Term

Introduction. Acute heart failure (AHF) is associated with a higher risk for the occurrence of rehospitalization and death. Galectin-3 (GAL3) is elevated in AHF patients and is an indicator in predicting short-term mortality. The total body water using bioimpedance vector analysis (BIVA) is able to identify mortality within AHF patients. The aim of this study was to evaluate the short- and long-term predictive value of GAL3, BIVA, and the combination of both in AHF patients in Emergency Department (ED).Methods. 205 ED patients with AHF were evaluated by testing for B type natriuretic peptide (BNP) and GAL3. The primary endpoint was death and rehospitalization at 30, 60, 90, and 180 days and 12 and 18 months. AHF patients were evaluated at the moment of ED arrival with clinical judgment and GAL3 and BIVA measurement.Results. GAL3 level was significantly higher in patients >71 years old, and witheGFR<30 cc/min. The area under the curve (AUC) ofGAL3+BIVA, GAL3 and BIVA for death and rehospitalization both when considered in total and when considered serially for the follow-up period showed that the combination has a better prognostic value. Kaplan-Meier survival curve for GAL3 values >17.8 ng/mL shows significant survival difference. At multivariate Cox regression analysis GAL3 is an independent variable to predict death + rehospitalization with a value of 32.24 ng/mL at 30 days (P<0.005).Conclusion. In patients admitted for AHF an early assessment of GAL3 and BIVA seems to be useful in identifying patients at high risk for death and rehospitalization at short and long term. Combining the biomarker and the device could be of great utility since they monitor the severity of two pathophysiological different mechanisms: heart fibrosis and fluid overload.

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Natural History of Cutaneous Human Polyomavirus Infection in Healthy Individuals

Frontiers in Microbiology ◽

10.3389/fmicb.2021.740947 ◽

2021 ◽

Vol 12 ◽

Author(s):

Luisa Bopp ◽

Ulrike Wieland ◽

Martin Hellmich ◽

Alexander Kreuter ◽

Herbert Pfister ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Human Polyomavirus ◽

Merkel Cell ◽

Healthy Individuals ◽

Short Term ◽

Viral Loads ◽

Short And Long Term ◽

Collection Period

Several human polyomaviruses (HPyVs) were recently discovered. Merkel cell polyomavirus (MCPyV) induces Merkel cell carcinoma. HPyV6, HPyV7, and TSPyV have been associated with rare skin lesions in immunosuppressed patients. HPyV9, HPyV10, and Saint Louis Polyomavirus (STLPyV) have not been convincingly associated with any disease. The aim of this prospective study was to evaluate the cutaneous prevalence, persistence and viral load of HPyVs in healthy individuals. Eight hundred seventy forehead and hand swabs were collected from 109 volunteers 4–6 weeks apart (collection period-1). Fifty-nine participants were available for follow-up a decade later (collection period-2). HPyV-DNA prevalence and viral loads of MCPyV, HPyV6, HPyV7, TSPyV, HPyV9, HPyV10, and STLPyV were determined by virus-specific real-time PCRs. Risk factors for HPyV prevalence, short- and long-term persistence were explored by logistic regression analyses. Baseline prevalence rates were similar for forehead and hand: MCPyV 67.9/67.0%, HPyV6 31.2/25.7%, HPyV7 13.8/11.0%, HPyV10 11.9/15.6%, STLPyV 7.3/8.3%, TSPyV 0.9/0.9%, and HPyV9 0.9/0.9%. Short-term persistence in period-1 was found in 59.6% (MCPyV), 23.9% (HPyV6), 10.1% (HPyV7), 6.4% (HPyV10), 5.5% (STLPyV), and 0% (TSPyV and HPyV9) on the forehead, with similar values for the hand. Long-term persistence for 9–12 years occurred only for MCPyV (forehead/hand 39.0%/44.1% of volunteers), HPyV6 (16.9%/11.9%), and HPyV7 (3.4%/5.1%). Individuals with short-term persistence had significantly higher viral loads at baseline compared to those with transient DNA-positivity (p < 0.001 for MCPyV, HPyV6, HPyV7, and HPyV10, respectively). This was also true for median viral loads in period-1 of MCPyV, HPyV6, and HPyV7 of volunteers with long-term persistence. Multiplicity (two or more different HPyVs) was a risk factor for prevalence and persistence for most HPyVs. Further risk factors were older age for HPyV6 and male sex for MCPyV on the forehead. Smoking was not a risk factor. In contrast to MCPyV, HPyV6, HPyV7, and rarely STLPyV, polyomaviruses TSPyV, HPyV9, and HPyV10 do not seem to be long-term constituents of the human skin virome of healthy individuals. Furthermore, this study showed that higher viral loads are associated with both short- and long-term persistence of HPyVs on the skin. HPyV multiplicity is a risk factor for prevalence, short-term and/or long-term persistence of MCPyV, HPyV6, HPyV7, and HPyV10.

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