M Batlle1, B Campos2, M Farrero3, M Cardona3, B González4, M A Castel3, J Ortiz3, E Roig5, M J Pulgarín6, J Ramírez7, J L Bedini4, M Sabaté6, P García de Frutos8, F Pérez-Villa3. 1. Institute of Biomedical Research August Pi i Sunyer (IDIBAPS) and the Cardiovascular Clinic Institute, Hospital Clínic de Barcelona, Spain. Electronic address: mbatlle@clinic.cat. 2. Department of Public Health, Universitat de Barcelona, Spain. 3. Heart Failure and Transplant Unit, Cardiovascular Clinic Institute, Hospital Clínic de Barcelona and researcher at Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Spain. 4. Core Laboratory, Hospital Clínic de Barcelona, Spain. 5. Heart Failure Unit at the Cardiology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica (IIB Sant Pau), Universitat Autònoma de Barcelona, Spain. 6. Institute of Biomedical Research August Pi i Sunyer (IDIBAPS) and the Cardiovascular Clinic Institute, Hospital Clínic de Barcelona, Spain. 7. Pathological Anatomy Department, Hospital Clínic de Barcelona, Spain. 8. Department of Cell Death and Proliferation at Institut d'Investigacions Biomèdiques de Barcelona (IIBB-CSIC) and IDIBAPS, Spain.
Abstract
BACKGROUND: Prognostic biomarkers are needed to improve the management of the heart failure (HF) epidemic, being the brain natriuretic peptides the most valuable. Here we evaluate 3 biomarkers, high sensitivity troponin T (hs-TnT), galectin-3 (Gal-3) and C-terminal propeptide of type I procollagen (CICP), compare them with a recently described new candidate (sAXL), and analyze their relationship with BNP. METHODS: HF patients with reduced ejection fraction (n=192) were included in this prospective observational study, with measurements of candidate biomarkers, functional, clinical and echocardiographic variables. A Cox regression model was used to determine predictors for clinical events, i.e. all-cause mortality and heart transplantation. RESULTS: Hs-TnT circulating values were correlated to clinical characteristics indicative of more advanced HF. When analyzing the event-free survival at a mean follow-up of 3.6years, patients in the higher quartile of either BNP, hs-TnT, CICP and sAXL had increased risk of suffering a clinical event, but not Gal-3. Combination of high sAXL and BNP values had greater predictive value (HR 6.8) than high BNP alone (HR 4.9). In a multivariate Cox regression analysis, BNP, sAXL and NYHA class were independent risk factors for clinical events. CONCLUSIONS: In this HF cohort, hs-TnT is a good HF marker and has a very significant prognostic value. The prognostic value of CICP and sAXL was of less significance. However, hs-TnT did not add predictive value to BNP, while sAXL did. This suggests that elevated troponin has a common origin with BNP, while sAXL could represent an independent pathological mechanism.
BACKGROUND: Prognostic biomarkers are needed to improve the management of the heart failure (HF) epidemic, being the brain natriuretic peptides the most valuable. Here we evaluate 3 biomarkers, high sensitivity troponin T (hs-TnT), galectin-3 (Gal-3) and C-terminal propeptide of type I procollagen (CICP), compare them with a recently described new candidate (sAXL), and analyze their relationship with BNP. METHODS: HF patients with reduced ejection fraction (n=192) were included in this prospective observational study, with measurements of candidate biomarkers, functional, clinical and echocardiographic variables. A Cox regression model was used to determine predictors for clinical events, i.e. all-cause mortality and heart transplantation. RESULTS: Hs-TnT circulating values were correlated to clinical characteristics indicative of more advanced HF. When analyzing the event-free survival at a mean follow-up of 3.6years, patients in the higher quartile of either BNP, hs-TnT, CICP and sAXL had increased risk of suffering a clinical event, but not Gal-3. Combination of high sAXL and BNP values had greater predictive value (HR 6.8) than high BNP alone (HR 4.9). In a multivariate Cox regression analysis, BNP, sAXL and NYHA class were independent risk factors for clinical events. CONCLUSIONS: In this HF cohort, hs-TnT is a good HF marker and has a very significant prognostic value. The prognostic value of CICP and sAXL was of less significance. However, hs-TnT did not add predictive value to BNP, while sAXL did. This suggests that elevated troponin has a common origin with BNP, while sAXL could represent an independent pathological mechanism.
Keywords:
AXL receptor tyrosine kinase; C-terminal propeptide of type I procollagen; Galectin-3; Heart failure; High sensitivity troponin T; Myocardial damage; Prognosis
Authors: M Batlle; B Campos; M Farrero; M Cardona; B González; M A Castel; J Ortiz; E Roig; M J Pulgarín; J Ramírez; J L Bedini; M Sabaté; P García de Frutos; F Pérez-Villa Journal: Data Brief Date: 2016-11-03
Authors: Montserrat Batlle; Nadia Castillo; Anna Alcarraz; Sebastian Sarvari; Gemma Sangüesa; Helena Cristóbal; Pablo García de Frutos; Marta Sitges; Lluis Mont; Eduard Guasch Journal: PLoS One Date: 2019-06-10 Impact factor: 3.240
Authors: Sonia Mirabet; Alvaro García-Osuna; Pablo Garcia de Frutos; Andreu Ferrero-Gregori; Vicens Brossa; Laura Lopez; Ruben Leta; Joan Garcia-Picart; Josep M Padro; José Luis Sánchez-Quesada; Juan Cinca; Jordi Ordonez-Llanos; Eulalia Roig Journal: Dis Markers Date: 2018-08-29 Impact factor: 3.434