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JACC Heart Fail. 2017 Apr;5(4):256-264. doi: 10.1016/j.jchf.2017.01.008.

Limited Added Value of Circulating Inflammatory Biomarkers in Chronic Heart Failure.

Author information

1
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: snymo@rr-research.no.
2
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
3
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
4
British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom.
5
Castle Hill Hospital, Hull York Medical School, University of Hull, Kingston-upon-Hull, United Kingdom.
6
Sahlgrenska University Hospital, Gothenburg, Sweden.
7
scPharmaceuticals, Lexington, Massachusetts.
8
Roche Diagnostics, Penzberg, Germany.
9
Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
10
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
11
Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.
12
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway.
13
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Center for Heart Failure Research, University of Oslo, Oslo, Norway.
14
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway.

Abstract

OBJECTIVES:

This study sought to evaluate whether a panel of biomarkers improved prognostication in patients with heart failure (HF) and reduced ejection fraction of ischemic origin using a systematized approach according to suggested requirements for validation of new biomarkers.

BACKGROUND:

Modeling combinations of multiple circulating markers could potentially identify patients with HF at particularly high risk and aid in the selection of individualized therapy.

METHODS:

From a panel of 20 inflammatory and extracellular matrix biomarkers, 2 different biomarker panels were created and added to the Seattle HF score and the prognostic model from the CORONA (Controlled Rosuvastatin Multinational Trial in Heart Failure) study (n = 1,497), which included conventional clinical characteristics and C-reactive protein and N-terminal pro-B-type natriuretic peptide. Interactions with statin treatment were also assessed.

RESULTS:

The two models-model 1 (endostatin, interleukin 8, soluble ST2, troponin T, galectin 3, and chemokine [C-C motif] ligand 21) and model 2 (troponin T, soluble ST2, galectin 3, pentraxin 3, and soluble tumor necrosis factor receptor 2)-significantly improved the CORONA and Seattle HF models but added only modestly to their Harrell's C statistic and net reclassification index. In addition, rosuvastatin had no effect on the levels of a wide range of inflammatory and extracellular matrix markers, but there was a tendency for patients with a lower level of biomarkers in the 2 panels to have a positive effect from statin treatment.

CONCLUSIONS:

In the specific HF patient population studied, a multimarker approach using the particular panel of biomarkers measured was of limited clinical value for identifying future risk of adverse outcomes.

KEYWORDS:

biomarkers; chronic ischemic heart disease; heart failure; inflammation; mortality; survival

PMID:
28359413
DOI:
10.1016/j.jchf.2017.01.008
[Indexed for MEDLINE]
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