Abstract
BACKGROUND: Heart failure (HF) biomarkers have prognostic value. The aim of this study was to combine HF biomarkers into an objective classification system for risk stratification of patients with HF.
METHODS: HF biomarkers were analyzed in a population of HF outpatients and expressed relative to their cut-off values (N-terminal pro-B-type natriuretic peptide [NT-proBNP] >1,000 pg/mL, soluble suppression of tumorigenesis-2 [ST2] >35 ng/mL, growth differentiation factor-15 [GDF-15] >2,000 pg/mL, and fibroblast growth factor-23 [FGF-23] >95.4 pg/mL). Biomarkers that remained significant in multivariable analysis were combined to devise the Heartmarker score. The performance of the Heartmarker score was compared to the widely used New York Heart Association (NYHA) classification based on symptoms during ordinary activity.
RESULTS: HF biomarkers of 245 patients were analyzed, 45 (18%) of whom experienced the composite endpoint of HF hospitalization, appropriate implantable cardioverter-defibrillator shock, or death. HF biomarkers were elevated more often in patients that reached the composite endpoint than in patients that did not reach the endpoint. NT-proBNP, ST2, and GDF-15 were independent predictors of the composite endpoint and were thus combined as the Heartmarker score. The event-free survival and distance covered in 6 minutes of walking decreased with an increasing Heartmarker score. Compared with the NYHA classification, the Heartmarker score was better at discriminating between different risk classes and had a comparable relationship to functional capacity.
CONCLUSIONS: The Heartmarker score is a reproducible and intuitive model for risk stratification of outpatients with HF, using routine biomarker measurements.
Original language | English |
---|---|
Pages (from-to) | 253-262 |
Number of pages | 10 |
Journal | Annals of Laboratory Medicine |
Volume | 43 |
Issue number | 3 |
DOIs | |
Publication status | Published - 1 May 2023 |
Keywords
- Humans
- Prognosis
- Growth Differentiation Factor 15
- Interleukin-1 Receptor-Like 1 Protein
- Heart Failure/diagnosis
- Biomarkers
- Peptide Fragments
- Natriuretic Peptide, Brain
- Heart failure
- Soluble suppression of tumorigenesis-2
- Growth differentiation factor-15
- N-terminal pro-B-type natriuretic peptide
Fingerprint
Dive into the research topics of 'Prognostic Value of Combined Biomarkers in Patients With Heart Failure: The Heartmarker Score'. Together they form a unique fingerprint.Research areas
-
Cardiovascular Medicine
van de Laar, L. (Content manager) & Jansen, J. (Content manager)
Impact: Research Topic/Theme (at group level)