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Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients
AIMS: The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite‐based biomarkers that has shown to improve the diagnostic value of N terminal pro B type natriuretic peptide (NT‐proBNP). However, little is known about its usefulness in predicting outcomes. In this study, we developed a...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524071/ https://www.ncbi.nlm.nih.gov/pubmed/32860352 http://dx.doi.org/10.1002/ehf2.12928 |
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author | McGranaghan, Peter Düngen, Hans‐Dirk Saxena, Anshul Rubens, Muni Salami, Joseph Radenkovic, Jasmin Bach, Doris Apostolovic, Svetlana Loncar, Goran Zdravkovic, Marija Tahirovic, Elvis Veskovic, Jovan Störk, Stefan Veledar, Emir Pieske, Burkert Edelmann, Frank Trippel, Tobias Daniel |
author_facet | McGranaghan, Peter Düngen, Hans‐Dirk Saxena, Anshul Rubens, Muni Salami, Joseph Radenkovic, Jasmin Bach, Doris Apostolovic, Svetlana Loncar, Goran Zdravkovic, Marija Tahirovic, Elvis Veskovic, Jovan Störk, Stefan Veledar, Emir Pieske, Burkert Edelmann, Frank Trippel, Tobias Daniel |
author_sort | McGranaghan, Peter |
collection | PubMed |
description | AIMS: The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite‐based biomarkers that has shown to improve the diagnostic value of N terminal pro B type natriuretic peptide (NT‐proBNP). However, little is known about its usefulness in predicting outcomes. In this study, we developed a risk score for 4‐year cardiovascular death in elderly chronic heart failure (CHF) patients using the CLP. METHODS AND RESULTS: From the Cardiac Insufficiency Bisoprolol Study in Elderly trial, we included 280 patients with CHF aged >65 years. A targeted metabolomic analysis of the CLP biomarkers was performed on baseline serum samples. Cox regression was used to determine the association of the biomarkers with the outcome after accounting for established risk factors. A risk score ranging from 0 to 4 was calculated by counting the number of biomarkers above the cut‐offs, using Youden index. During the mean (standard deviation) follow‐up period of 50 (8) months, 35 (18%) subjects met the primary endpoint of cardiovascular death. The area under the receiver operating curve for the model based on clinical variables was 0.84, the second model with NT‐proBNP was 0.86, and the final model with the CLP was 0.90. The categorical net reclassification index was 0.25 using three risk categories: 0–60% (low), 60–85% (intermediate), and >85% (high). The continuous net reclassification index was 0.772, and the integrated discrimination index was 0.104. CONCLUSIONS: In patients with CHF, incorporating a panel of three metabolite‐based biomarkers into a risk score improved the prognostic utility of NT‐proBNP by predicting long‐term cardiovascular death more precisely. This novel approach holds promise to improve clinical risk assessment in CHF patients. |
format | Online Article Text |
id | pubmed-7524071 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75240712020-10-02 Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients McGranaghan, Peter Düngen, Hans‐Dirk Saxena, Anshul Rubens, Muni Salami, Joseph Radenkovic, Jasmin Bach, Doris Apostolovic, Svetlana Loncar, Goran Zdravkovic, Marija Tahirovic, Elvis Veskovic, Jovan Störk, Stefan Veledar, Emir Pieske, Burkert Edelmann, Frank Trippel, Tobias Daniel ESC Heart Fail Original Research Articles AIMS: The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite‐based biomarkers that has shown to improve the diagnostic value of N terminal pro B type natriuretic peptide (NT‐proBNP). However, little is known about its usefulness in predicting outcomes. In this study, we developed a risk score for 4‐year cardiovascular death in elderly chronic heart failure (CHF) patients using the CLP. METHODS AND RESULTS: From the Cardiac Insufficiency Bisoprolol Study in Elderly trial, we included 280 patients with CHF aged >65 years. A targeted metabolomic analysis of the CLP biomarkers was performed on baseline serum samples. Cox regression was used to determine the association of the biomarkers with the outcome after accounting for established risk factors. A risk score ranging from 0 to 4 was calculated by counting the number of biomarkers above the cut‐offs, using Youden index. During the mean (standard deviation) follow‐up period of 50 (8) months, 35 (18%) subjects met the primary endpoint of cardiovascular death. The area under the receiver operating curve for the model based on clinical variables was 0.84, the second model with NT‐proBNP was 0.86, and the final model with the CLP was 0.90. The categorical net reclassification index was 0.25 using three risk categories: 0–60% (low), 60–85% (intermediate), and >85% (high). The continuous net reclassification index was 0.772, and the integrated discrimination index was 0.104. CONCLUSIONS: In patients with CHF, incorporating a panel of three metabolite‐based biomarkers into a risk score improved the prognostic utility of NT‐proBNP by predicting long‐term cardiovascular death more precisely. This novel approach holds promise to improve clinical risk assessment in CHF patients. John Wiley and Sons Inc. 2020-08-28 /pmc/articles/PMC7524071/ /pubmed/32860352 http://dx.doi.org/10.1002/ehf2.12928 Text en © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Articles McGranaghan, Peter Düngen, Hans‐Dirk Saxena, Anshul Rubens, Muni Salami, Joseph Radenkovic, Jasmin Bach, Doris Apostolovic, Svetlana Loncar, Goran Zdravkovic, Marija Tahirovic, Elvis Veskovic, Jovan Störk, Stefan Veledar, Emir Pieske, Burkert Edelmann, Frank Trippel, Tobias Daniel Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
title | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
title_full | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
title_fullStr | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
title_full_unstemmed | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
title_short | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
title_sort | incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524071/ https://www.ncbi.nlm.nih.gov/pubmed/32860352 http://dx.doi.org/10.1002/ehf2.12928 |
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