Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort

Muhammed T. Gürgöze; K. Martijn Akkerhuis; Rohit M. Oemrawsingh; Victor A.W.M. Umans; Bas Kietselaer; Carl E. Schotborgh; Eelko Ronner; Timo Lenderink; Ismail Aksoy; Pim Van Der Harst; Folkert W. Asselbergs; Arthur C. Maas; Anton J. Oude Ophuis; Boudewijn Krenning; Robbert J. De Winter; Salem H.K. The; Alexander J. Wardeh; Walter R.M. Hermans; G. Etienne Cramer; Ina Van Gorp; Yolanda B. De Rijke; Ron H.N. Van Schaik; Eric Boersma

doi:10.1093/ehjacc/zuad042

Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort

Muhammed T. Gürgöze
, K. Martijn Akkerhuis
, Rohit M. Oemrawsingh
, Victor A.W.M. Umans
, Bas Kietselaer
, Carl E. Schotborgh
, Eelko Ronner
, Timo Lenderink
, Ismail Aksoy
, Pim Van Der Harst
, Folkert W. Asselbergs
, Arthur C. Maas
, Anton J. Oude Ophuis
, Boudewijn Krenning
, Robbert J. De Winter
, Salem H.K. The
, Alexander J. Wardeh
, Walter R.M. Hermans
, G. Etienne Cramer
, Ina Van Gorp

Yolanda B. De Rijke, Ron H.N. Van Schaik, Eric Boersma^*

^*Corresponding author for this work

Northwest Clinics Alkmaar
Zuyderland Medical Center (Heerlen)
Mayo Clinic Rochester, MN
Haga Ziekenhuis
Department of Cardiology
University Medical Centre Groningen
Utrecht University
University of Amsterdam
University College London
Canisius Wilhelmina Hospital
Treant Zorggroep
Haaglanden Medisch Centrum
ETZ Elisabeth
Radboud University Medical Center

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

4 Citations (Scopus)

56 Downloads (Pure)

Abstract

Aims: Evidence regarding the role of serial measurements of biomarkers for risk assessment in post-acute coronary syndrome (ACS) patients is limited. The aim was to explore the prognostic value of four, serially measured biomarkers in a large, real-world cohort of post-ACS patients. Methods and results: BIOMArCS is a prospective, multi-centre, observational study in 844 post-ACS patients in whom 12 218 blood samples (median 17 per patient) were obtained during 1-year follow-up. The longitudinal patterns of high-sensitivity cardiac troponin T (hs-cTnT), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and growth differentiation factor 15 (GDF-15) were analysed in relation to the primary endpoint (PE) of cardiovascular mortality and recurrent ACS using multivariable joint models. Median age was 63 years, 78% were men and the PE was reached by 45 patients. The average biomarker levels were systematically higher in PE compared with PE-free patients. After adjustment for 6-month post-discharge Global Registry of Acute Coronary Events score, 1 standard deviation increase in log[hs-cTnT] was associated with a 61% increased risk of the PE [hazard ratio (HR) 1.61, 95% confidence interval (CI) 1.02-2.44, P = 0.045], while for log[GDF-15] this was 81% (HR 1.81, 95% CI 1.28-2.70, P = 0.001). These associations remained significant after multivariable adjustment, while NT-proBNP and hs-CRP were not. Furthermore, GDF-15 level showed an increasing trend prior to the PE (Structured Graphical Abstract). Conclusion: Longitudinally measured hs-cTnT and GDF-15 concentrations provide prognostic value in the risk assessment of clinically stabilized patients post-ACS. Clinical Trial Registration: The Netherlands Trial Register. Currently available at URL https://trialsearch.who.int/; Unique Identifiers: NTR1698 and NTR1106.

Original language	English
Pages (from-to)	451-461
Number of pages	11
Journal	European Heart Journal: Acute Cardiovascular Care
Volume	12
Issue number	7
DOIs	https://doi.org/10.1093/ehjacc/zuad042
Publication status	Published - 1 Jul 2023

Bibliographical note

Funding Information:
Roche Diagnostics provided assays and kits in support of this work (‘COBAS C, COBAS E and ELECSYS are trademarks of Roche’). This study was supported and funded by the Netherlands Heart Foundation (grant number 2007B012); The Netherlands Heart Institute-Interuniversity Cardiology Institute of Netherlands (project number 071.01); the Working Group of Cardiovascular Research Netherlands, all of which are non-commercial funding bodies, and an unrestricted research grant was further obtained from Eli Lilly, the Netherlands.

Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.

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Gürgöze, M. T., Akkerhuis, K. M., Oemrawsingh, R. M., Umans, V. A. W. M., Kietselaer, B., Schotborgh, C. E., Ronner, E., Lenderink, T., Aksoy, I., Van Der Harst, P., Asselbergs, F. W., Maas, A. C., Oude Ophuis, A. J., Krenning, B., De Winter, R. J., The, S. H. K., Wardeh, A. J., Hermans, W. R. M., Cramer, G. E., ... Boersma, E. (2023). Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort. European Heart Journal: Acute Cardiovascular Care, 12(7), 451-461. https://doi.org/10.1093/ehjacc/zuad042

Gürgöze, Muhammed T. ; Akkerhuis, K. Martijn ; Oemrawsingh, Rohit M. et al. / Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome : the BIOMArCS cohort. In: European Heart Journal: Acute Cardiovascular Care. 2023 ; Vol. 12, No. 7. pp. 451-461.

@article{d8628a870a78475ea1b40bfe54a39fc5,

title = "Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort",

abstract = "Aims: Evidence regarding the role of serial measurements of biomarkers for risk assessment in post-acute coronary syndrome (ACS) patients is limited. The aim was to explore the prognostic value of four, serially measured biomarkers in a large, real-world cohort of post-ACS patients. Methods and results: BIOMArCS is a prospective, multi-centre, observational study in 844 post-ACS patients in whom 12 218 blood samples (median 17 per patient) were obtained during 1-year follow-up. The longitudinal patterns of high-sensitivity cardiac troponin T (hs-cTnT), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and growth differentiation factor 15 (GDF-15) were analysed in relation to the primary endpoint (PE) of cardiovascular mortality and recurrent ACS using multivariable joint models. Median age was 63 years, 78\% were men and the PE was reached by 45 patients. The average biomarker levels were systematically higher in PE compared with PE-free patients. After adjustment for 6-month post-discharge Global Registry of Acute Coronary Events score, 1 standard deviation increase in log[hs-cTnT] was associated with a 61\% increased risk of the PE [hazard ratio (HR) 1.61, 95\% confidence interval (CI) 1.02-2.44, P = 0.045], while for log[GDF-15] this was 81\% (HR 1.81, 95\% CI 1.28-2.70, P = 0.001). These associations remained significant after multivariable adjustment, while NT-proBNP and hs-CRP were not. Furthermore, GDF-15 level showed an increasing trend prior to the PE (Structured Graphical Abstract). Conclusion: Longitudinally measured hs-cTnT and GDF-15 concentrations provide prognostic value in the risk assessment of clinically stabilized patients post-ACS. Clinical Trial Registration: The Netherlands Trial Register. Currently available at URL https://trialsearch.who.int/; Unique Identifiers: NTR1698 and NTR1106.",

author = "G{\"u}rg{\"o}ze, \{Muhammed T.\} and Akkerhuis, \{K. Martijn\} and Oemrawsingh, \{Rohit M.\} and Umans, \{Victor A.W.M.\} and Bas Kietselaer and Schotborgh, \{Carl E.\} and Eelko Ronner and Timo Lenderink and Ismail Aksoy and \{Van Der Harst\}, Pim and Asselbergs, \{Folkert W.\} and Maas, \{Arthur C.\} and \{Oude Ophuis\}, \{Anton J.\} and Boudewijn Krenning and \{De Winter\}, \{Robbert J.\} and The, \{Salem H.K.\} and Wardeh, \{Alexander J.\} and Hermans, \{Walter R.M.\} and Cramer, \{G. Etienne\} and \{Van Gorp\}, Ina and \{De Rijke\}, \{Yolanda B.\} and \{Van Schaik\}, \{Ron H.N.\} and Eric Boersma",

note = "Funding Information: Roche Diagnostics provided assays and kits in support of this work ({\textquoteleft}COBAS C, COBAS E and ELECSYS are trademarks of Roche{\textquoteright}). This study was supported and funded by the Netherlands Heart Foundation (grant number 2007B012); The Netherlands Heart Institute-Interuniversity Cardiology Institute of Netherlands (project number 071.01); the Working Group of Cardiovascular Research Netherlands, all of which are non-commercial funding bodies, and an unrestricted research grant was further obtained from Eli Lilly, the Netherlands. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2023",

month = jul,

day = "1",

doi = "10.1093/ehjacc/zuad042",

language = "English",

volume = "12",

pages = "451--461",

journal = "European Heart Journal: Acute Cardiovascular Care",

issn = "2048-8726",

publisher = "Oxford University Press",

number = "7",

}

Gürgöze, MT, Akkerhuis, KM, Oemrawsingh, RM, Umans, VAWM, Kietselaer, B, Schotborgh, CE, Ronner, E, Lenderink, T, Aksoy, I, Van Der Harst, P, Asselbergs, FW, Maas, AC, Oude Ophuis, AJ, Krenning, B, De Winter, RJ, The, SHK, Wardeh, AJ, Hermans, WRM, Cramer, GE, Van Gorp, I, De Rijke, YB, Van Schaik, RHN & Boersma, E 2023, 'Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort', European Heart Journal: Acute Cardiovascular Care, vol. 12, no. 7, pp. 451-461. https://doi.org/10.1093/ehjacc/zuad042

Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort. / Gürgöze, Muhammed T.; Akkerhuis, K. Martijn; Oemrawsingh, Rohit M. et al.
In: European Heart Journal: Acute Cardiovascular Care, Vol. 12, No. 7, 01.07.2023, p. 451-461.

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

TY - JOUR

T1 - Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome

T2 - the BIOMArCS cohort

AU - Gürgöze, Muhammed T.

AU - Akkerhuis, K. Martijn

AU - Oemrawsingh, Rohit M.

AU - Umans, Victor A.W.M.

AU - Kietselaer, Bas

AU - Schotborgh, Carl E.

AU - Ronner, Eelko

AU - Lenderink, Timo

AU - Aksoy, Ismail

AU - Van Der Harst, Pim

AU - Asselbergs, Folkert W.

AU - Maas, Arthur C.

AU - Oude Ophuis, Anton J.

AU - Krenning, Boudewijn

AU - De Winter, Robbert J.

AU - The, Salem H.K.

AU - Wardeh, Alexander J.

AU - Hermans, Walter R.M.

AU - Cramer, G. Etienne

AU - Van Gorp, Ina

AU - De Rijke, Yolanda B.

AU - Van Schaik, Ron H.N.

AU - Boersma, Eric

N1 - Funding Information: Roche Diagnostics provided assays and kits in support of this work (‘COBAS C, COBAS E and ELECSYS are trademarks of Roche’). This study was supported and funded by the Netherlands Heart Foundation (grant number 2007B012); The Netherlands Heart Institute-Interuniversity Cardiology Institute of Netherlands (project number 071.01); the Working Group of Cardiovascular Research Netherlands, all of which are non-commercial funding bodies, and an unrestricted research grant was further obtained from Eli Lilly, the Netherlands. Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Aims: Evidence regarding the role of serial measurements of biomarkers for risk assessment in post-acute coronary syndrome (ACS) patients is limited. The aim was to explore the prognostic value of four, serially measured biomarkers in a large, real-world cohort of post-ACS patients. Methods and results: BIOMArCS is a prospective, multi-centre, observational study in 844 post-ACS patients in whom 12 218 blood samples (median 17 per patient) were obtained during 1-year follow-up. The longitudinal patterns of high-sensitivity cardiac troponin T (hs-cTnT), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and growth differentiation factor 15 (GDF-15) were analysed in relation to the primary endpoint (PE) of cardiovascular mortality and recurrent ACS using multivariable joint models. Median age was 63 years, 78% were men and the PE was reached by 45 patients. The average biomarker levels were systematically higher in PE compared with PE-free patients. After adjustment for 6-month post-discharge Global Registry of Acute Coronary Events score, 1 standard deviation increase in log[hs-cTnT] was associated with a 61% increased risk of the PE [hazard ratio (HR) 1.61, 95% confidence interval (CI) 1.02-2.44, P = 0.045], while for log[GDF-15] this was 81% (HR 1.81, 95% CI 1.28-2.70, P = 0.001). These associations remained significant after multivariable adjustment, while NT-proBNP and hs-CRP were not. Furthermore, GDF-15 level showed an increasing trend prior to the PE (Structured Graphical Abstract). Conclusion: Longitudinally measured hs-cTnT and GDF-15 concentrations provide prognostic value in the risk assessment of clinically stabilized patients post-ACS. Clinical Trial Registration: The Netherlands Trial Register. Currently available at URL https://trialsearch.who.int/; Unique Identifiers: NTR1698 and NTR1106.

AB - Aims: Evidence regarding the role of serial measurements of biomarkers for risk assessment in post-acute coronary syndrome (ACS) patients is limited. The aim was to explore the prognostic value of four, serially measured biomarkers in a large, real-world cohort of post-ACS patients. Methods and results: BIOMArCS is a prospective, multi-centre, observational study in 844 post-ACS patients in whom 12 218 blood samples (median 17 per patient) were obtained during 1-year follow-up. The longitudinal patterns of high-sensitivity cardiac troponin T (hs-cTnT), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and growth differentiation factor 15 (GDF-15) were analysed in relation to the primary endpoint (PE) of cardiovascular mortality and recurrent ACS using multivariable joint models. Median age was 63 years, 78% were men and the PE was reached by 45 patients. The average biomarker levels were systematically higher in PE compared with PE-free patients. After adjustment for 6-month post-discharge Global Registry of Acute Coronary Events score, 1 standard deviation increase in log[hs-cTnT] was associated with a 61% increased risk of the PE [hazard ratio (HR) 1.61, 95% confidence interval (CI) 1.02-2.44, P = 0.045], while for log[GDF-15] this was 81% (HR 1.81, 95% CI 1.28-2.70, P = 0.001). These associations remained significant after multivariable adjustment, while NT-proBNP and hs-CRP were not. Furthermore, GDF-15 level showed an increasing trend prior to the PE (Structured Graphical Abstract). Conclusion: Longitudinally measured hs-cTnT and GDF-15 concentrations provide prognostic value in the risk assessment of clinically stabilized patients post-ACS. Clinical Trial Registration: The Netherlands Trial Register. Currently available at URL https://trialsearch.who.int/; Unique Identifiers: NTR1698 and NTR1106.

UR - https://www.scopus.com/pages/publications/85165722967

U2 - 10.1093/ehjacc/zuad042

DO - 10.1093/ehjacc/zuad042

M3 - Article

C2 - 37096818

AN - SCOPUS:85165722967

SN - 2048-8726

VL - 12

SP - 451

EP - 461

JO - European Heart Journal: Acute Cardiovascular Care

JF - European Heart Journal: Acute Cardiovascular Care

IS - 7

ER -

Gürgöze MT, Akkerhuis KM, Oemrawsingh RM, Umans VAWM, Kietselaer B, Schotborgh CE et al. Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort. European Heart Journal: Acute Cardiovascular Care. 2023 Jul 1;12(7):451-461. doi: 10.1093/ehjacc/zuad042

Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort

Abstract

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