Head-to-Head Comparison of Serial Soluble ST2, Growth Differentiation Factor-15, and Highly-Sensitive Troponin T Measurements in Patients With Chronic Heart Failure

Hanna K. Gaggin; Jackie Szymonifka; Anju Bhardwaj; Arianna Belcher; Benedetta De Berardinis; Shweta Motiwala; Thomas J. Wang; James L. Januzzi

doi:10.1016/j.jchf.2013.10.005

Head-to-Head Comparison of Serial Soluble ST2, Growth Differentiation Factor-15, and Highly-Sensitive Troponin T Measurements in Patients With Chronic Heart Failure

Hanna K. Gaggin, Jackie Szymonifka, Anju Bhardwaj, Arianna Belcher, Benedetta De Berardinis, Shweta Motiwala, Thomas J. Wang, James L. Januzzi

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

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Abstract

Objectives: This analysis aimed to perform a head-to-head comparison of 3 of the promising biomarkers of cardiovascular (CV) outcomes in heart failure (HF)-soluble ST2 (sST2), growth differentiation factor (GDF)-15, and highly-sensitive troponin T (hsTnT)-and to evaluate the role of serial measurement of these biomarkers in patients with chronic HF. Background: sST2, GDF-15, and hsTnT are strongly associated with CV outcomes in HF. Methods: This post-hoc analysis used data from a study in which 151 patients with chronic HF due to left ventricular systolic dysfunction were followed up over 10 months. At each visit, N-terminal pro-B-type natriuretic peptide (NT-proBNP), sST2, GDF-15, and hsTnT were measured and any major CV events were recorded. Results: Baseline values of all 3 novel biomarkers independently predicted total CV events even after adjusting for clinical and biochemical characteristics, including NT-proBNP, with the best model including all 3 biomarkers (p < 0.001). Adding serial measurement to the base model appeared to improve the model's predictive ability (with sST2 showing the most promise), but it is not clear whether this addition is a unique contribution. However, when time-dependent factors were included, only sST2 serial measurement independently added to the risk model (odds ratio: 3.64; 95% confidence interval: 1.37 to 9.67; p = 0.009) and predicted reverse myocardial remodeling (odds ratio: 1.22; 95% confidence interval: 1.04 to 1.43; p = 0.01). Conclusions: In patients with chronic HF, baseline measurement of novel biomarkers added independent prognostic information to clinical variables and NT-proBNP. Only serial measurement of sST2 appeared to add prognostic information to baseline concentrations and predicted change in left ventricular function. (Use of NT-proBNP Testing to Guide Heart Failure Therapy in the Outpatient Setting (PROTECT)]; NCT00351390).

Original language	English (US)
Pages (from-to)	65-72
Number of pages	8
Journal	JACC: Heart Failure
Volume	2
Issue number	1
DOIs	https://doi.org/10.1016/j.jchf.2013.10.005
State	Published - Feb 2014
Externally published	Yes

Keywords

Biomarker
Heart failure
Prognosis

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.jchf.2013.10.005

Cite this

Gaggin, H. K., Szymonifka, J., Bhardwaj, A., Belcher, A., De Berardinis, B., Motiwala, S., Wang, T. J., & Januzzi, J. L. (2014). Head-to-Head Comparison of Serial Soluble ST2, Growth Differentiation Factor-15, and Highly-Sensitive Troponin T Measurements in Patients With Chronic Heart Failure. JACC: Heart Failure, 2(1), 65-72. https://doi.org/10.1016/j.jchf.2013.10.005

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title = "Head-to-Head Comparison of Serial Soluble ST2, Growth Differentiation Factor-15, and Highly-Sensitive Troponin T Measurements in Patients With Chronic Heart Failure",

abstract = "Objectives: This analysis aimed to perform a head-to-head comparison of 3 of the promising biomarkers of cardiovascular (CV) outcomes in heart failure (HF)-soluble ST2 (sST2), growth differentiation factor (GDF)-15, and highly-sensitive troponin T (hsTnT)-and to evaluate the role of serial measurement of these biomarkers in patients with chronic HF. Background: sST2, GDF-15, and hsTnT are strongly associated with CV outcomes in HF. Methods: This post-hoc analysis used data from a study in which 151 patients with chronic HF due to left ventricular systolic dysfunction were followed up over 10 months. At each visit, N-terminal pro-B-type natriuretic peptide (NT-proBNP), sST2, GDF-15, and hsTnT were measured and any major CV events were recorded. Results: Baseline values of all 3 novel biomarkers independently predicted total CV events even after adjusting for clinical and biochemical characteristics, including NT-proBNP, with the best model including all 3 biomarkers (p < 0.001). Adding serial measurement to the base model appeared to improve the model's predictive ability (with sST2 showing the most promise), but it is not clear whether this addition is a unique contribution. However, when time-dependent factors were included, only sST2 serial measurement independently added to the risk model (odds ratio: 3.64; 95% confidence interval: 1.37 to 9.67; p = 0.009) and predicted reverse myocardial remodeling (odds ratio: 1.22; 95% confidence interval: 1.04 to 1.43; p = 0.01). Conclusions: In patients with chronic HF, baseline measurement of novel biomarkers added independent prognostic information to clinical variables and NT-proBNP. Only serial measurement of sST2 appeared to add prognostic information to baseline concentrations and predicted change in left ventricular function. (Use of NT-proBNP Testing to Guide Heart Failure Therapy in the Outpatient Setting (PROTECT)]; NCT00351390).",

keywords = "Biomarker, Heart failure, Prognosis",

author = "Gaggin, {Hanna K.} and Jackie Szymonifka and Anju Bhardwaj and Arianna Belcher and {De Berardinis}, Benedetta and Shweta Motiwala and Wang, {Thomas J.} and Januzzi, {James L.}",

note = "Funding Information: Dr. Gaggin is supported in part by the Ruth and James Clark Fund for Cardiac Research Innovation. Drs. Bhardwaj and Motiwala were supported by the Dennis and Marilyn Barry Cardiology Fellowship. Dr. Wang has received research or assay support from DiaSorin, Brahms, Critical Diagnostics, LabCorp, and Siemens Diagnostics ; has received honoraria from Roche, DiaSorin, and Quest Diagnostics; has served on the medical advisory board of Singulex; and is named as coinventor on patent applications relating to the use of metabolomic or neurohormonal biomarkers in risk prediction. Dr. Januzzi is supported in part by the Roman W . DeSanctis Clinical Scholar Endowment and has received grants from Roche Diagnostics, Siemens, Critical Diagnostics, Singulex, and Thermo Fisher . All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. John R. Teerlink, MD, served as Guest Editor for this paper. ",

year = "2014",

month = feb,

doi = "10.1016/j.jchf.2013.10.005",

language = "English (US)",

volume = "2",

pages = "65--72",

journal = "JACC: Heart Failure",

issn = "2213-1779",

publisher = "Elsevier BV",

number = "1",

}

TY - JOUR

T1 - Head-to-Head Comparison of Serial Soluble ST2, Growth Differentiation Factor-15, and Highly-Sensitive Troponin T Measurements in Patients With Chronic Heart Failure

AU - Gaggin, Hanna K.

AU - Szymonifka, Jackie

AU - Bhardwaj, Anju

AU - Belcher, Arianna

AU - De Berardinis, Benedetta

AU - Motiwala, Shweta

AU - Wang, Thomas J.

AU - Januzzi, James L.

N1 - Funding Information: Dr. Gaggin is supported in part by the Ruth and James Clark Fund for Cardiac Research Innovation. Drs. Bhardwaj and Motiwala were supported by the Dennis and Marilyn Barry Cardiology Fellowship. Dr. Wang has received research or assay support from DiaSorin, Brahms, Critical Diagnostics, LabCorp, and Siemens Diagnostics ; has received honoraria from Roche, DiaSorin, and Quest Diagnostics; has served on the medical advisory board of Singulex; and is named as coinventor on patent applications relating to the use of metabolomic or neurohormonal biomarkers in risk prediction. Dr. Januzzi is supported in part by the Roman W . DeSanctis Clinical Scholar Endowment and has received grants from Roche Diagnostics, Siemens, Critical Diagnostics, Singulex, and Thermo Fisher . All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. John R. Teerlink, MD, served as Guest Editor for this paper.

PY - 2014/2

Y1 - 2014/2

N2 - Objectives: This analysis aimed to perform a head-to-head comparison of 3 of the promising biomarkers of cardiovascular (CV) outcomes in heart failure (HF)-soluble ST2 (sST2), growth differentiation factor (GDF)-15, and highly-sensitive troponin T (hsTnT)-and to evaluate the role of serial measurement of these biomarkers in patients with chronic HF. Background: sST2, GDF-15, and hsTnT are strongly associated with CV outcomes in HF. Methods: This post-hoc analysis used data from a study in which 151 patients with chronic HF due to left ventricular systolic dysfunction were followed up over 10 months. At each visit, N-terminal pro-B-type natriuretic peptide (NT-proBNP), sST2, GDF-15, and hsTnT were measured and any major CV events were recorded. Results: Baseline values of all 3 novel biomarkers independently predicted total CV events even after adjusting for clinical and biochemical characteristics, including NT-proBNP, with the best model including all 3 biomarkers (p < 0.001). Adding serial measurement to the base model appeared to improve the model's predictive ability (with sST2 showing the most promise), but it is not clear whether this addition is a unique contribution. However, when time-dependent factors were included, only sST2 serial measurement independently added to the risk model (odds ratio: 3.64; 95% confidence interval: 1.37 to 9.67; p = 0.009) and predicted reverse myocardial remodeling (odds ratio: 1.22; 95% confidence interval: 1.04 to 1.43; p = 0.01). Conclusions: In patients with chronic HF, baseline measurement of novel biomarkers added independent prognostic information to clinical variables and NT-proBNP. Only serial measurement of sST2 appeared to add prognostic information to baseline concentrations and predicted change in left ventricular function. (Use of NT-proBNP Testing to Guide Heart Failure Therapy in the Outpatient Setting (PROTECT)]; NCT00351390).

AB - Objectives: This analysis aimed to perform a head-to-head comparison of 3 of the promising biomarkers of cardiovascular (CV) outcomes in heart failure (HF)-soluble ST2 (sST2), growth differentiation factor (GDF)-15, and highly-sensitive troponin T (hsTnT)-and to evaluate the role of serial measurement of these biomarkers in patients with chronic HF. Background: sST2, GDF-15, and hsTnT are strongly associated with CV outcomes in HF. Methods: This post-hoc analysis used data from a study in which 151 patients with chronic HF due to left ventricular systolic dysfunction were followed up over 10 months. At each visit, N-terminal pro-B-type natriuretic peptide (NT-proBNP), sST2, GDF-15, and hsTnT were measured and any major CV events were recorded. Results: Baseline values of all 3 novel biomarkers independently predicted total CV events even after adjusting for clinical and biochemical characteristics, including NT-proBNP, with the best model including all 3 biomarkers (p < 0.001). Adding serial measurement to the base model appeared to improve the model's predictive ability (with sST2 showing the most promise), but it is not clear whether this addition is a unique contribution. However, when time-dependent factors were included, only sST2 serial measurement independently added to the risk model (odds ratio: 3.64; 95% confidence interval: 1.37 to 9.67; p = 0.009) and predicted reverse myocardial remodeling (odds ratio: 1.22; 95% confidence interval: 1.04 to 1.43; p = 0.01). Conclusions: In patients with chronic HF, baseline measurement of novel biomarkers added independent prognostic information to clinical variables and NT-proBNP. Only serial measurement of sST2 appeared to add prognostic information to baseline concentrations and predicted change in left ventricular function. (Use of NT-proBNP Testing to Guide Heart Failure Therapy in the Outpatient Setting (PROTECT)]; NCT00351390).

KW - Biomarker

KW - Heart failure

KW - Prognosis

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Head-to-Head Comparison of Serial Soluble ST2, Growth Differentiation Factor-15, and Highly-Sensitive Troponin T Measurements in Patients With Chronic Heart Failure

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