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 | |
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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In: International Journal of Cardiology, Vol. 277, 15.02.2019, p. 166-172.
Research output: Contribution to journal › Article › Academic › peer-review
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 -