TY - JOUR
T1 - Stabilization patterns and variability of hs-CRP, NT-proBNP and ST2 during 1 year after acute coronary syndrome admission
T2 - results of the BIOMArCS study
AU - van den Berg, Victor J.
AU - Umans, Victor A. W. M.
AU - Brankovic, Milos
AU - Oemrawsingh, Rohit M.
AU - Asselbergs, Folkert W.
AU - van der Harst, Pim
AU - Hoefer, Imo E.
AU - Kietselaer, Bas
AU - Crijns, Harry J. G. M.
AU - Lenderink, Timo
AU - Ophuis, Anton J. Oude
AU - van Schaik, Ron H.
AU - Kardys, Isabella
AU - Boersma, Eric
AU - Akkerhuis, K. Martijn
AU - BIOMArCS Investigators
N1 - Funding Information:
Research funding: This study was funded by Eli Lilly and Company, Funder Id: http://dx.doi.org/10.13039/ 100004312 ; ICIN Netherlands Heart Institute, Funder Id: http://dx.doi.org/10.13039/501100006006 , Grant Number: project number: 071.01.
Publisher Copyright:
© 2020 Eric Boersma et al., published by De Gruyter, Berlin/Boston.
PY - 2020/12
Y1 - 2020/12
N2 - Objectives: Details of the biological variability of high-sensitivity C-reactive protein (hs-CRP), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and ST2 are currently lacking in patients with acute coronary syndrome (ACS) but are crucial knowledge when aiming to use these biomarkers for personalized risk prediction. In the current study, we report post-ACS kinetics and the variability of the hs-CRP, NT-proBNP and ST2.Methods: BIOMArCS is a prospective, observational study with high frequency blood sampling during 1 year post-ACS. Using 1507 blood samples from 191 patients that remained free from adverse cardiac events, we investigated post-ACS kinetics of hs-CRP, NT-proBNP and S12. Biological variability was studied using the samples collected between 6 and 12 months after the index ACS, when patients were considered to have stable coronary artery disease.Results: On average, hs-CRP rose peaked at day 2 and rose well above the reference value. ST2 peaked immediately after the ACS but never rose above the reference value. NT-proBNP level rose on average during the first 2 days post-ACS and slowly declined afterwards. The within-subject variation and relative change value (RCV) of ST2 were relatively small (13.8%, RCV 39.7%), while hs-CRP (41.9%, lognormal RCV 206.1/-67.3%) and NT-proBNP (39.0%, lognormal RCV 185.2/-6/1.9%) showed a considerable variation.Conclusions: Variability of hs-CRP and NT-proBNP within asymptomatic and clinically stable post-ACS patients is considerable. In contrast, within-patient variability of ST2 is low. Given the low within-subject variation, ST2 might be the most useful biomarker for personalizing risk prediction in stable post-ACS patients.
AB - Objectives: Details of the biological variability of high-sensitivity C-reactive protein (hs-CRP), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and ST2 are currently lacking in patients with acute coronary syndrome (ACS) but are crucial knowledge when aiming to use these biomarkers for personalized risk prediction. In the current study, we report post-ACS kinetics and the variability of the hs-CRP, NT-proBNP and ST2.Methods: BIOMArCS is a prospective, observational study with high frequency blood sampling during 1 year post-ACS. Using 1507 blood samples from 191 patients that remained free from adverse cardiac events, we investigated post-ACS kinetics of hs-CRP, NT-proBNP and S12. Biological variability was studied using the samples collected between 6 and 12 months after the index ACS, when patients were considered to have stable coronary artery disease.Results: On average, hs-CRP rose peaked at day 2 and rose well above the reference value. ST2 peaked immediately after the ACS but never rose above the reference value. NT-proBNP level rose on average during the first 2 days post-ACS and slowly declined afterwards. The within-subject variation and relative change value (RCV) of ST2 were relatively small (13.8%, RCV 39.7%), while hs-CRP (41.9%, lognormal RCV 206.1/-67.3%) and NT-proBNP (39.0%, lognormal RCV 185.2/-6/1.9%) showed a considerable variation.Conclusions: Variability of hs-CRP and NT-proBNP within asymptomatic and clinically stable post-ACS patients is considerable. In contrast, within-patient variability of ST2 is low. Given the low within-subject variation, ST2 might be the most useful biomarker for personalizing risk prediction in stable post-ACS patients.
KW - acute coronary syndrome (ACS)
KW - C-reactive protein (CRP)
KW - myocardial infarction
KW - N-terminal prohormone of brain natriuretic peptide (NTproBNP)
KW - ST2
KW - variability
KW - C-REACTIVE PROTEIN
KW - CHRONIC HEART-FAILURE
KW - ACUTE MYOCARDIAL-INFARCTION
KW - NATRIURETIC PEPTIDE
KW - SOLUBLE ST2
KW - BIOLOGICAL VARIATION
KW - PROGNOSTIC VALUE
KW - ARTERY-DISEASE
KW - TERMINAL PROBNP
KW - MORTALITY
U2 - 10.1515/cclm-2019-1320
DO - 10.1515/cclm-2019-1320
M3 - Article
C2 - 32383686
SN - 1434-6621
VL - 58
SP - 2099
EP - 2106
JO - Clinical Chemistry and Laboratory Medicine
JF - Clinical Chemistry and Laboratory Medicine
IS - 12
ER -