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 -