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Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction

ST-elevation myocardial infarction (STEMI) is one of the main reasons for morbidity and mortality worldwide. In addition to the classic biomarker NT-proBNP, new biomarkers like ST2 and Pentraxin-3 (Ptx-3) have emerged as potential tools in stratifying risk in cardiac patients. Indeed, multimarker ap...

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Autores principales: Zagidullin, Naufal, Motloch, Lukas J., Gareeva, Diana, Hamitova, Aysilu, Lakman, Irina, Krioni, Ilja, Popov, Denis, Zulkarneev, Rustem, Paar, Vera, Kopp, Kristen, Jirak, Peter, Ishmetov, Vladimir, Hoppe, Uta C., Tulbaev, Eduard, Pavlov, Valentin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073894/
https://www.ncbi.nlm.nih.gov/pubmed/32085400
http://dx.doi.org/10.3390/jcm9020550
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author Zagidullin, Naufal
Motloch, Lukas J.
Gareeva, Diana
Hamitova, Aysilu
Lakman, Irina
Krioni, Ilja
Popov, Denis
Zulkarneev, Rustem
Paar, Vera
Kopp, Kristen
Jirak, Peter
Ishmetov, Vladimir
Hoppe, Uta C.
Tulbaev, Eduard
Pavlov, Valentin
author_facet Zagidullin, Naufal
Motloch, Lukas J.
Gareeva, Diana
Hamitova, Aysilu
Lakman, Irina
Krioni, Ilja
Popov, Denis
Zulkarneev, Rustem
Paar, Vera
Kopp, Kristen
Jirak, Peter
Ishmetov, Vladimir
Hoppe, Uta C.
Tulbaev, Eduard
Pavlov, Valentin
author_sort Zagidullin, Naufal
collection PubMed
description ST-elevation myocardial infarction (STEMI) is one of the main reasons for morbidity and mortality worldwide. In addition to the classic biomarker NT-proBNP, new biomarkers like ST2 and Pentraxin-3 (Ptx-3) have emerged as potential tools in stratifying risk in cardiac patients. Indeed, multimarker approaches to estimate prognosis of STEMI patients have been proposed and their potential clinical impact requires investigation. In our study, in 147 patients with STEMI, NT-proBNP as well as serum levels of ST2 and Ptx-3 were evaluated. During two-year follow-up (FU; 734.2 ± 61.2 d) results were correlated with risk for cardiovascular mortality (CV-mortality). NT-proBNP (HR = 1.64, 95% CI = 1.21–2.21, p = 0.001) but also ST2 (HR = 1.000022, 95% CI = 1.00–1.001, p < 0.001) were shown to be reliable predictors of CV-mortality, while the highest predictive power was observed with Ptx-3 (HR = 3.1, 95% CI = 1.63–5.39, p < 0.001). When two biomarkers were combined in a multivariate Cox regression model, relevant improvement of risk assessment was only observed with NT-proBNP+Ptx-3 (AIC = 209, BIC = 214, p = 0.001, MER = 0.75, MEV = 0.64). However, the highest accuracy was seen using a three-marker approach (NT-proBNP + ST2 + Ptx-3: AIC = 208, BIC = 214, p < 0.001, MER = 0.77, MEV = 0.66). In conclusion, after STEMI, ST2 and Ptx-3 in addition to NT-proBNP were associated with the incidence of CV-mortality, with multimarker approaches enhancing the accuracy of prediction of CV-mortality.
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spelling pubmed-70738942020-03-19 Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction Zagidullin, Naufal Motloch, Lukas J. Gareeva, Diana Hamitova, Aysilu Lakman, Irina Krioni, Ilja Popov, Denis Zulkarneev, Rustem Paar, Vera Kopp, Kristen Jirak, Peter Ishmetov, Vladimir Hoppe, Uta C. Tulbaev, Eduard Pavlov, Valentin J Clin Med Article ST-elevation myocardial infarction (STEMI) is one of the main reasons for morbidity and mortality worldwide. In addition to the classic biomarker NT-proBNP, new biomarkers like ST2 and Pentraxin-3 (Ptx-3) have emerged as potential tools in stratifying risk in cardiac patients. Indeed, multimarker approaches to estimate prognosis of STEMI patients have been proposed and their potential clinical impact requires investigation. In our study, in 147 patients with STEMI, NT-proBNP as well as serum levels of ST2 and Ptx-3 were evaluated. During two-year follow-up (FU; 734.2 ± 61.2 d) results were correlated with risk for cardiovascular mortality (CV-mortality). NT-proBNP (HR = 1.64, 95% CI = 1.21–2.21, p = 0.001) but also ST2 (HR = 1.000022, 95% CI = 1.00–1.001, p < 0.001) were shown to be reliable predictors of CV-mortality, while the highest predictive power was observed with Ptx-3 (HR = 3.1, 95% CI = 1.63–5.39, p < 0.001). When two biomarkers were combined in a multivariate Cox regression model, relevant improvement of risk assessment was only observed with NT-proBNP+Ptx-3 (AIC = 209, BIC = 214, p = 0.001, MER = 0.75, MEV = 0.64). However, the highest accuracy was seen using a three-marker approach (NT-proBNP + ST2 + Ptx-3: AIC = 208, BIC = 214, p < 0.001, MER = 0.77, MEV = 0.66). In conclusion, after STEMI, ST2 and Ptx-3 in addition to NT-proBNP were associated with the incidence of CV-mortality, with multimarker approaches enhancing the accuracy of prediction of CV-mortality. MDPI 2020-02-18 /pmc/articles/PMC7073894/ /pubmed/32085400 http://dx.doi.org/10.3390/jcm9020550 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zagidullin, Naufal
Motloch, Lukas J.
Gareeva, Diana
Hamitova, Aysilu
Lakman, Irina
Krioni, Ilja
Popov, Denis
Zulkarneev, Rustem
Paar, Vera
Kopp, Kristen
Jirak, Peter
Ishmetov, Vladimir
Hoppe, Uta C.
Tulbaev, Eduard
Pavlov, Valentin
Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction
title Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction
title_full Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction
title_fullStr Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction
title_full_unstemmed Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction
title_short Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction
title_sort combining novel biomarkers for risk stratification of two-year cardiovascular mortality in patients with st-elevation myocardial infarction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073894/
https://www.ncbi.nlm.nih.gov/pubmed/32085400
http://dx.doi.org/10.3390/jcm9020550
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