Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1783506717618733056 |
---|---|
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. |
format | Online Article Text |
id | pubmed-7073894 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT zagidullinnaufal combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT motlochlukasj combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT gareevadiana combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT hamitovaaysilu combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT lakmanirina combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT krioniilja combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT popovdenis combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT zulkarneevrustem combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT paarvera combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT koppkristen combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT jirakpeter combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT ishmetovvladimir combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT hoppeutac combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT tulbaeveduard combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction AT pavlovvalentin combiningnovelbiomarkersforriskstratificationoftwoyearcardiovascularmortalityinpatientswithstelevationmyocardialinfarction |