Heart failure & cardiomyopathiesSecondary analysis
End-organ Protective Effect of Serelaxin in Patients Hospitalized for Heart Failure: Results of the Biomarker Substudy of Relaxin in Acute Heart Failure-2 (RELAX-AHF-2)
- Secondary analysis of the RELAX-AHF-2 randomised trial
- biomarker substudy
- pre-specified
Authors' conclusion
In this substudy, serelaxin decreased plasma concentrations of cardiac, renal and hepatic injury markers. Changes of most of these markers were associated with cardiovascular mortality. In this pre-specified biomarker subgroup, serelaxin did not reduce 180-day cardiovascular mortality but significantly reduced worsening heart failure through day 5.
Study context
- Population
- Patients enrolled within 16 h of presentation for HF hospitalizationof 6545 in RELAX-AHF-2
- Participants
- 1,020 patients
- Comparison
- Serelaxin vs placebo
- Primary endpoint
- Percentage change from baseline in organ damage-related biomarkers
Primary result
As reported in the abstract
Percentage change from baseline in biomarkers
| Group | Troponin T through day 14 | Creatinine at day 2 | Cystatin C at day 2 | Uric acid at day 2 | NT-proBNP to day 2 |
|---|---|---|---|---|---|
| Serelaxin | +0.2% | −0.8% | +3.8% | +0.8% | −39.8% |
| Placebo | +40.3% | +5.8% | +8.3% | +7.2% | −27.6% |
- Serelaxin vs Placebo: P = 0.042 — troponin T
- Serelaxin vs Placebo: P = 0.002 — creatinine
- Serelaxin vs Placebo: P = 0.016 — cystatin C
- Serelaxin vs Placebo: P = 0.0014 — uric acid
- Serelaxin vs Placebo: P = 0.002 — NT-proBNP
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| CV death · 180 days | 0.78 (0.49–1.25) | P = 0.30 | |
| Worsening HF · through day 5 | 0.55 (0.33–0.93) | P = 0.027 | |
| 0.20.5125Hazard ratio (log scale) |
Association of early biomarker changes with 180-day mortality
- Early changes in NT-proBNP and troponin, but not creatinine, cystatin C and uric acid, associated with 180-day mortality
Original publication
End-organ Protective Effect of Serelaxin in Patients Hospitalized for Heart Failure: Results of the Biomarker Substudy of Relaxin in Acute Heart Failure-2 (RELAX-AHF-2). Eur J Heart Fail. Published 12 December 2024. doi:10.1002/ejhf.3551
Summarised from the published abstract; every number is checked against it