Citations 1
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 , Umans, Victor A. , Kietselaer, Bas , Schotborgh, Carl E. , Lenderink, Timo , Aksoy, Ismail , Harst, Pim van der , Asselbergs, Folkert W. , Maas, Arthur , Ophuis, Anton J. Oude, Krenning, Boudewijn J., Winter, Robbert J. de , The, Salem H.K., Wardeh, Alexander J. , Hermans, Walter, Cramer, G. Etienne , Gorp, Ina van, Schaik, Ron H. N. van , Boersma, Eric , Lenderink, Timo , Boersma, Eric , van der Harst, Pim , Kietselaer, Bas L J H , Oemrawsingh, Rohit M. , Ronner, Eelko , de Rijke, Yolanda B
European Heart Journal: Acute Cardiovascular Care | April 25, 2023 | Volume: 12 | Issue: 7 | Pages: 451-461
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.