Limited added value of circulating inflammatory biomarkers in chronic heart failure

Nymo, S. H. et al. (2017) Limited added value of circulating inflammatory biomarkers in chronic heart failure. JACC: Heart Failure, 5(4), pp. 256-264. (doi:10.1016/j.jchf.2017.01.008) (PMID:28359413)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John and McMurray, Professor John
Authors: Nymo, S. H., Aukrust, P., Kjekshus, J., McMurray, J. J.V., Cleland, J. G.F., Wikstrand, J., Muntendam, P., Wienhues-Thelen, U., Latini, R., Tandberg Askevold, E., Gravning, J., Dahl, C. P., Broch, K., Yndestad, A., Gullestad, L., and Ueland, T.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:JACC: Heart Failure
Publisher:Elsevier
ISSN:2213-1779
ISSN (Online):2213-1787
Published Online:27 March 2017
Copyright Holders:Copyright © 2017 The American College of Cardiology Foundation
First Published:First published in JACC: Heart Failure 5(4): 256-264
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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