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Limited Added Value of Circulating Inflammatory Biomarkers in Chronic Heart Failure

2017; Elsevier BV; Volume: 5; Issue: 4 Linguagem: Inglês

10.1016/j.jchf.2017.01.008

2213-1787

Ståle H. Nymo, Pål Aukrust, John Kjekshus, John J.V. McMurray, John G.F. Cleland, John Wikstrand, Pieter Muntendam, Ursula Wienhues-Thelen, Roberto Latini, Erik T. Askevold, Jørgen Gravning, Christen P. Dahl, Kaspar Broch, Arne Yndestad, Lars Gullestad, Thor Ueland,

GDF15 and Related Biomarkers

OBJECTIVES/BACKGROUND: Modeling combinations of multiple circulating markers could potentially identify heart failure (HF) patients at particularly high risk and aid in the selection of individualized therapy.We evaluated if a panel of biomarkers improved prognostication in patients with HF with reduced ejection fraction of ischemic origin using a systematized approach according to suggested requirements for validation of new biomarkers METHODS: From a panel of 20 inflammatory and ECM biomarkers two different biomarker panels were created and added to the Seattle heart failure score, and the prognostic model from the CORONA study (n=1497) which included conventional clinical characteristics and C-reactive protein and Nterminal pro B-type Natriuretic Peptide.Interactions with statin treatment were also assessed. RESULTS:The two models, which were composed of (Model 1) endostatin, interleukin (IL)-8, sST2, TnT, galectin-3 and CCL21 and (Model 2) Troponin T, sST2, galectin-3, pentraxin 3, and sTNFR2 significantly improved the CORONA and Seattle HF models, but added only modestly to their Harrell's C statistic and NRI.In addition, there was no effect of rosuvastatin on the levels of a wide range of inflammatory and ECM markers, but there was a tendency of patients with lower level of biomarkers in the two panels to have a positive effect of statin treatment.CONCLUSIONS: A multi-marker approach using the particular panel of biomarkers measured, in the specific HF patient population studied, was of limited clinical value for identifying future risk of adverse outcomes.