Web of Science: 25 cites, Scopus: 25 cites, Google Scholar: cites,
Impact of diabetes on the predictive value of heart failure biomarkers
Alonso, Nuria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Lupón, Josep (Universitat Autònoma de Barcelona. Departament de Medicina)
Barallat, Jaume (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
de Antonio, Marta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domingo, Mar (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Zamora, Elisabet (Universitat Autònoma de Barcelona. Departament de Medicina)
Moliner, Pedro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Galán, Amparo (Department of Biochemistry, Hospital Universitario Marqués de Valdecilla, Santander, Spain)
Santesmases, Javier (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pastor, Cruz (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Mauricio, Dídac (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayes-Genis, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)

Data: 2016
Resum: Patients with diabetes mellitus (DM) have an increased risk of developing heart failure (HF). Further, DM is associated with poor prognosis in patients with HF. Our aim was to determine whether DM has any impact on the predictive value of a multi-biomarker panel in patients with HF. We included 1069 consecutive ambulatory HF patients in the study: age 66. 2 ± 12. 8 years, 33. 5 ± 13. 3 left ventricular ejection fraction, 36% diabetic patients. We measured serum concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hs-TnT), ST2, galectin-3, high-sensitivity C reactive protein (hs-CRP), cystatin-C, soluble transferrin receptor (sTfR), and neprilysin and followed patients for 4. 9 ± 2. 8 years. Primary endpoints were all-cause and cardiovascular death. During follow-up, 534 patients died; 283 died of cardiovascular causes. Diabetic subjects had higher mortality (57. 7 vs. 45. 6%, p < 0. 001). NTproBNP (p = 0. 07), hs-TnT (p < 0. 001), galectin-3 (p < 0. 001), and cystatin-C (p = 0. 001) concentrations were higher in diabetic patients, whereas sTfR levels were lower (p = 0. 005). There were no interactions between DM and NTproBNP, hs-TnT, galectin-3, hs-CRP, cystatin-C, sTfR, and neprilysin relative to risk prediction for all-cause or cardiovascular death. By contrast, ST2 significantly interacted with DM for all-cause (p = 0. 02) and cardiovascular (p = 0. 03) death. In diabetic patients, HRs for ST2 were 1. 27 (95% CI 1. 16-1. 40, p < 0. 001) and 1. 23 (95% CI 1. 09-1. 39, p = 0. 001) for all-cause and cardiovascular death, respectively. In nondiabetic patients, HRs for ST2 were 1. 53 (95% CI 1. 35-1. 73, p < 0. 001) and 1. 64 (95% CI 1. 31-2. 05, p < 0. 001) for all-cause and cardiovascular death, respectively. The multivariable Cox regression analysis showed that hs-TnT and ST2 were the only markers that were independently associated with both all-cause and cardiovascular mortality in patients with HF and diabetes. Moreover, in these patients, the combination of these two markers significantly increased discrimination as assessed by the area under the curve. Biomarkers used in the general population to predict the clinical course of heart failure are also useful in patients with diabetes. In these patients, among all the biomarkers analysed only hs-TnT and ST2 were independently associated with both all-cause and cardiovascular mortality.
Nota: Altres ajuts: This study was funded by the Redes Temáticas de Investigación Cooperativa en Salud (RETICS); Red Cardiovascular (RD12/0042/0047) as part of the Plan Nacional de I+D+I.
Nota: Número d'acord de subvenció ISCIII/FIS PI14-01682
Nota: Número d'acord de subvenció ISCIII/PI14-01772
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: article ; recerca ; publishedVersion
Matèria: Diabetes mellitus ; Heart failure ; Biomarkers ; ST2 ; Prognostic
Publicat a: Cardiovascular diabetology, Vol. 15 (november 2016) , ISSN 1475-2840

DOI: 10.1186/s12933-016-0470-x
PMID: 27809845


9 p, 1.4 MB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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 Registre creat el 2018-02-07, darrera modificació el 2020-11-12



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