High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure

Alberto Aimo; James L. Januzzi; Giuseppe Vergaro; Andrea Ripoli; Roberto Latini; Serge Masson; Michela Magnoli; Inder S. Anand; Jay N. Cohn; Luigi Tavazzi; Gianni Tognoni; Jorgen Gravning; Thor Ueland; Stale H. Nymo; Hans-Peter Brunner-La Rocca; Antoni Bayes-Genis; Josep Lupon; Rudolf A. de Boer; Akiomi Yoshihisa; Yasuchika Takeishi; Michael Egstrup; Ida Gustafsson; Hanna K. Gaggin; Kai M. Eggers; Kurt Huber; Loannis Tentzeris; W. H. Wilson Tang; Justin L. Grodin; Claudio Passino; Michele Emdin

doi:10.1016/j.ijcard.2018.10.079

High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure

Alberto Aimo^*, James L. Januzzi, Giuseppe Vergaro, Andrea Ripoli, Roberto Latini, Serge Masson, Michela Magnoli, Inder S. Anand, Jay N. Cohn, Luigi Tavazzi, Gianni Tognoni, Jorgen Gravning, Thor Ueland, Stale H. Nymo, Hans-Peter Brunner-La Rocca, Antoni Bayes-Genis, Josep Lupon, Rudolf A. de Boer, Akiomi Yoshihisa, Yasuchika TakeishiMichael Egstrup, Ida Gustafsson, Hanna K. Gaggin, Kai M. Eggers, Kurt Huber, Loannis Tentzeris, W. H. Wilson Tang, Justin L. Grodin, Claudio Passino, Michele Emdin

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.

Methods and results: 9289 patients (66 +/- 12 years, 77% men, 85% LVEF = 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR <30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes.

Conclusions: hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance. (C) 2018 Elsevier B.V. All rights reserved.

Original language	English
Pages (from-to)	166-172
Number of pages	7
Journal	International Journal of Cardiology
Volume	277
DOIs	https://doi.org/10.1016/j.ijcard.2018.10.079
Publication status	Published - 15 Feb 2019

Keywords

Heart failure
Troponin
Renal function
Prognosis
GROWTH-DIFFERENTIATION FACTOR-15
LEFT-VENTRICULAR DYSFUNCTION
3RD UNIVERSAL DEFINITION
C-REACTIVE PROTEIN
EPIDEMIOLOGY COLLABORATION
PROGNOSTIC VALUE
TASK-FORCE
BIOMARKERS
GALECTIN-3
MORTALITY

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10.1016/j.ijcard.2018.10.079

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Aimo, A., Januzzi, J. L., Vergaro, G., Ripoli, A., Latini, R., Masson, S., Magnoli, M., Anand, I. S., Cohn, J. N., Tavazzi, L., Tognoni, G., Gravning, J., Ueland, T., Nymo, S. H., Brunner-La Rocca, H.-P., Bayes-Genis, A., Lupon, J., de Boer, R. A., Yoshihisa, A., ... Emdin, M. (2019). High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure. International Journal of Cardiology, 277, 166-172. https://doi.org/10.1016/j.ijcard.2018.10.079

@article{4d272a84e20d4df0a2aa12faa618b328,

title = "High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure",

abstract = "Background: In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.Methods and results: 9289 patients (66 +/- 12 years, 77% men, 85% LVEF = 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR <30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes.Conclusions: hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance. (C) 2018 Elsevier B.V. All rights reserved.",

keywords = "Heart failure, Troponin, Renal function, Prognosis, GROWTH-DIFFERENTIATION FACTOR-15, LEFT-VENTRICULAR DYSFUNCTION, 3RD UNIVERSAL DEFINITION, C-REACTIVE PROTEIN, EPIDEMIOLOGY COLLABORATION, PROGNOSTIC VALUE, TASK-FORCE, BIOMARKERS, GALECTIN-3, MORTALITY",

author = "Alberto Aimo and Januzzi, {James L.} and Giuseppe Vergaro and Andrea Ripoli and Roberto Latini and Serge Masson and Michela Magnoli and Anand, {Inder S.} and Cohn, {Jay N.} and Luigi Tavazzi and Gianni Tognoni and Jorgen Gravning and Thor Ueland and Nymo, {Stale H.} and {Brunner-La Rocca}, Hans-Peter and Antoni Bayes-Genis and Josep Lupon and {de Boer}, {Rudolf A.} and Akiomi Yoshihisa and Yasuchika Takeishi and Michael Egstrup and Ida Gustafsson and Gaggin, {Hanna K.} and Eggers, {Kai M.} and Kurt Huber and Loannis Tentzeris and Tang, {W. H. Wilson} and Grodin, {Justin L.} and Claudio Passino and Michele Emdin",

note = "Funding Information: Dr. Januzzi has received grant support from Siemens, Singulex, and Prevencio; consulting income from Roche Diagnostics, Critical Diagnostics, Philips, and Novartis; and participates in clinical end point committees for Novartis, Amgen, Janssen, and Boehringer Ingelheim. Dr. Latini and Dr. Masson have received grant support and travel reimbursements from Roche Diagnostics. Dr. Tavazzi reports personal fees from Servier, personal fees from CVIE Therapeutics, outside the submitted work. Dr. Gravning reports lecture fees from AstraZeneca, Siemens and Abbott Laboratories, outside the submitted work. Dr. Brunner-La Rocca reports unrestricted research grants and consulting fees from Roche Diagnostics, as well as unrestricted research grants from Novartis and Vifor outside this work. Dr. Bayes-Genis has received grant support from Roche Diagnosis, lecture honoraria from Roche Diagnostics and Critical Diagnostics, and consulting income from Roche Diagnostics, Critical Diagnostics, and Novartis. Dr. Lup{\'o}n has received lecture honoraria from Roche Diagnostics. Dr. de Boer reports that Roche, Novartis, and AstraZeneca offered consultancy to UMCG; he also reports grants from AstraZeneca, grants from Bristol Myers Squibb, and grants from Trevena, outside the submitted work. Dr. Gustafsson reports personal fees from Boehringer-Ingelheim, personal fees from Novo Nordisk, personal fees from Novartis, personal fees from MSD, personal fees from Astra-Zeneca, outside the submitted work. Dr. Gaggin has received grant support from Roche and Portola; consulting income from Roche Diagnostics, Amgen and Ortho Clinical; research payments for clinical endpoint committees for EchoSense and Radiometer. Dr. Eggers has received honoraria from Abbott Laboratories and AstraZeneca, and has served as a consultant for Abbott Laboratories and Fiomi Diagnostics. Dr. Tang reports grants from National Institutes of Health, outside the submitted work. All disclosed relationships are modest. All other Authors have nothing to disclose. Funding Information: Dr. Januzzi has received grant support from Siemens , Singulex , and Prevencio ; consulting income from Roche Diagnostics, Critical Diagnostics, Philips, and Novartis; and participates in clinical end point committees for Novartis, Amgen, Janssen, and Boehringer Ingelheim. Dr. Latini and Dr. Masson have received grant support and travel reimbursements from Roche Diagnostics. Dr. Tavazzi reports personal fees from Servier, personal fees from CVIE Therapeutics, outside the submitted work. Dr. Gravning reports lecture fees from AstraZeneca, Siemens and Abbott Laboratories, outside the submitted work. Dr. Brunner-La Rocca reports unrestricted research grants and consulting fees from Roche Diagnostics, as well as unrestricted research grants from Novartis and Vifor outside this work. Dr. Bayes-Genis has received grant support from Roche Diagnosis, lecture honoraria from Roche Diagnostics and Critical Diagnostics, and consulting income from Roche Diagnostics, Critical Diagnostics, and Novartis. Dr. Lup{\'o}n has received lecture honoraria from Roche Diagnostics. Dr. de Boer reports that Roche, Novartis, and AstraZeneca offered consultancy to UMCG; he also reports grants from AstraZeneca, grants from Bristol Myers Squibb, and grants from Trevena, outside the submitted work. Dr. Gustafsson reports personal fees from Boehringer-Ingelheim, personal fees from Novo Nordisk, personal fees from Novartis, personal fees from MSD, personal fees from Astra-Zeneca, outside the submitted work. Dr. Gaggin has received grant support from Roche and Portola; consulting income from Roche Diagnostics, Amgen and Ortho Clinical; research payments for clinical endpoint committees for EchoSense and Radiometer. Dr. Eggers has received honoraria from Abbott Laboratories and AstraZeneca, and has served as a consultant for Abbott Laboratories and Fiomi Diagnostics. Dr. Tang reports grants from National Institutes of Health, outside the submitted work. All disclosed relationships are modest. All other Authors have nothing to disclose. Publisher Copyright: {\textcopyright} 2018 Elsevier B.V.",

year = "2019",

month = feb,

day = "15",

doi = "10.1016/j.ijcard.2018.10.079",

language = "English",

volume = "277",

pages = "166--172",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

Aimo, A, Januzzi, JL, Vergaro, G, Ripoli, A, Latini, R, Masson, S, Magnoli, M, Anand, IS, Cohn, JN, Tavazzi, L, Tognoni, G, Gravning, J, Ueland, T, Nymo, SH, Brunner-La Rocca, H-P, Bayes-Genis, A, Lupon, J, de Boer, RA, Yoshihisa, A, Takeishi, Y, Egstrup, M, Gustafsson, I, Gaggin, HK, Eggers, KM, Huber, K, Tentzeris, L, Tang, WHW, Grodin, JL, Passino, C & Emdin, M 2019, 'High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure', International Journal of Cardiology, vol. 277, pp. 166-172. https://doi.org/10.1016/j.ijcard.2018.10.079

TY - JOUR

T1 - High-sensitivity troponin T, NT-proBNP and glomerular filtration rate

T2 - A multimarker strategy for risk stratification in chronic heart failure

AU - Aimo, Alberto

AU - Januzzi, James L.

AU - Vergaro, Giuseppe

AU - Ripoli, Andrea

AU - Latini, Roberto

AU - Masson, Serge

AU - Magnoli, Michela

AU - Anand, Inder S.

AU - Cohn, Jay N.

AU - Tavazzi, Luigi

AU - Tognoni, Gianni

AU - Gravning, Jorgen

AU - Ueland, Thor

AU - Nymo, Stale H.

AU - Brunner-La Rocca, Hans-Peter

AU - Bayes-Genis, Antoni

AU - Lupon, Josep

AU - de Boer, Rudolf A.

AU - Yoshihisa, Akiomi

AU - Takeishi, Yasuchika

AU - Egstrup, Michael

AU - Gustafsson, Ida

AU - Gaggin, Hanna K.

AU - Eggers, Kai M.

AU - Huber, Kurt

AU - Tentzeris, Loannis

AU - Tang, W. H. Wilson

AU - Grodin, Justin L.

AU - Passino, Claudio

AU - Emdin, Michele

N1 - Funding Information: Dr. Januzzi has received grant support from Siemens, Singulex, and Prevencio; consulting income from Roche Diagnostics, Critical Diagnostics, Philips, and Novartis; and participates in clinical end point committees for Novartis, Amgen, Janssen, and Boehringer Ingelheim. Dr. Latini and Dr. Masson have received grant support and travel reimbursements from Roche Diagnostics. Dr. Tavazzi reports personal fees from Servier, personal fees from CVIE Therapeutics, outside the submitted work. Dr. Gravning reports lecture fees from AstraZeneca, Siemens and Abbott Laboratories, outside the submitted work. Dr. Brunner-La Rocca reports unrestricted research grants and consulting fees from Roche Diagnostics, as well as unrestricted research grants from Novartis and Vifor outside this work. Dr. Bayes-Genis has received grant support from Roche Diagnosis, lecture honoraria from Roche Diagnostics and Critical Diagnostics, and consulting income from Roche Diagnostics, Critical Diagnostics, and Novartis. Dr. Lupón has received lecture honoraria from Roche Diagnostics. Dr. de Boer reports that Roche, Novartis, and AstraZeneca offered consultancy to UMCG; he also reports grants from AstraZeneca, grants from Bristol Myers Squibb, and grants from Trevena, outside the submitted work. Dr. Gustafsson reports personal fees from Boehringer-Ingelheim, personal fees from Novo Nordisk, personal fees from Novartis, personal fees from MSD, personal fees from Astra-Zeneca, outside the submitted work. Dr. Gaggin has received grant support from Roche and Portola; consulting income from Roche Diagnostics, Amgen and Ortho Clinical; research payments for clinical endpoint committees for EchoSense and Radiometer. Dr. Eggers has received honoraria from Abbott Laboratories and AstraZeneca, and has served as a consultant for Abbott Laboratories and Fiomi Diagnostics. Dr. Tang reports grants from National Institutes of Health, outside the submitted work. All disclosed relationships are modest. All other Authors have nothing to disclose. Funding Information: Dr. Januzzi has received grant support from Siemens , Singulex , and Prevencio ; consulting income from Roche Diagnostics, Critical Diagnostics, Philips, and Novartis; and participates in clinical end point committees for Novartis, Amgen, Janssen, and Boehringer Ingelheim. Dr. Latini and Dr. Masson have received grant support and travel reimbursements from Roche Diagnostics. Dr. Tavazzi reports personal fees from Servier, personal fees from CVIE Therapeutics, outside the submitted work. Dr. Gravning reports lecture fees from AstraZeneca, Siemens and Abbott Laboratories, outside the submitted work. Dr. Brunner-La Rocca reports unrestricted research grants and consulting fees from Roche Diagnostics, as well as unrestricted research grants from Novartis and Vifor outside this work. Dr. Bayes-Genis has received grant support from Roche Diagnosis, lecture honoraria from Roche Diagnostics and Critical Diagnostics, and consulting income from Roche Diagnostics, Critical Diagnostics, and Novartis. Dr. Lupón has received lecture honoraria from Roche Diagnostics. Dr. de Boer reports that Roche, Novartis, and AstraZeneca offered consultancy to UMCG; he also reports grants from AstraZeneca, grants from Bristol Myers Squibb, and grants from Trevena, outside the submitted work. Dr. Gustafsson reports personal fees from Boehringer-Ingelheim, personal fees from Novo Nordisk, personal fees from Novartis, personal fees from MSD, personal fees from Astra-Zeneca, outside the submitted work. Dr. Gaggin has received grant support from Roche and Portola; consulting income from Roche Diagnostics, Amgen and Ortho Clinical; research payments for clinical endpoint committees for EchoSense and Radiometer. Dr. Eggers has received honoraria from Abbott Laboratories and AstraZeneca, and has served as a consultant for Abbott Laboratories and Fiomi Diagnostics. Dr. Tang reports grants from National Institutes of Health, outside the submitted work. All disclosed relationships are modest. All other Authors have nothing to disclose. Publisher Copyright: © 2018 Elsevier B.V.

PY - 2019/2/15

Y1 - 2019/2/15

N2 - Background: In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.Methods and results: 9289 patients (66 +/- 12 years, 77% men, 85% LVEF = 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR <30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes.Conclusions: hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance. (C) 2018 Elsevier B.V. All rights reserved.

AB - Background: In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.Methods and results: 9289 patients (66 +/- 12 years, 77% men, 85% LVEF = 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR <30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes.Conclusions: hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance. (C) 2018 Elsevier B.V. All rights reserved.

KW - Heart failure

KW - Troponin

KW - Renal function

KW - Prognosis

KW - GROWTH-DIFFERENTIATION FACTOR-15

KW - LEFT-VENTRICULAR DYSFUNCTION

KW - 3RD UNIVERSAL DEFINITION

KW - C-REACTIVE PROTEIN

KW - EPIDEMIOLOGY COLLABORATION

KW - PROGNOSTIC VALUE

KW - TASK-FORCE

KW - BIOMARKERS

KW - GALECTIN-3

KW - MORTALITY

U2 - 10.1016/j.ijcard.2018.10.079

DO - 10.1016/j.ijcard.2018.10.079

M3 - Article

C2 - 30416028

SN - 0167-5273

VL - 277

SP - 166

EP - 172

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -