Heart failure & cardiomyopathies
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)
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
Methodological detailsbiomarker substudy, pre-specified
- Biomarker substudy
- Pre-specified
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% |
Troponin T through day 14
Serelaxin+0.2%
Placebo+40.3%
Creatinine at day 2
Serelaxin−0.8%
Placebo+5.8%
Cystatin C at day 2
Serelaxin+3.8%
Placebo+8.3%
Uric acid at day 2
Serelaxin+0.8%
Placebo+7.2%
NT-proBNP to day 2
Serelaxin−39.8%
Placebo−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.
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