Heart failure & cardiomyopathies
Multimarker Analysis of Serially Measured GDF-15, NT-proBNP, ST2, GAL-3, cTnI, Creatinine, and Prognosis in Acute Heart Failure
Authors' conclusion
Sequentially measured GDF-15 independently and dynamically predicts risk of adverse outcomes during 1-year follow-up after index admission for acute HF. NT-proBNP remains a robust predictor among potential candidates.
Study context
- Population
- Patients with acute heart failure (HF), 14 hospitals in the Netherlands, 2009–2014
- Participants
- 496 patients
- Outcome
- Composite of:
- All-cause mortality
- HF rehospitalization
- Follow-up
- 1-year follow-up
Methodological detailsmulticentre, 14 hospitals in the Netherlands, serial biomarker measurements, multivariable joint modeling, Blood sampling scheduled at 7 moments during 1-year follow-up; biomarkers measured in a central laboratory
- Multicentre
- 14 hospitals in the Netherlands
- Serial biomarker measurements
- Multivariable joint modeling
- Blood sampling scheduled at 7 moments during 1-year follow-up; biomarkers measured in a central laboratory
Main finding
As reported in the abstract
GDF-15 (per 1 SD log)Hazard ratio (95% CI)
Unadjusted
2.14(1.78–2.57)
Adjusted for clinical confounders
1.96(1.49–2.53)
Jointly modeled with all biomarkers
1.44(1.05–1.91)
Per 1 SD log, as printed
- Primary end point reached
- 188 (40%)
Observational data: associations, not effects.
Further findings
Primary end point by serial NT-proBNP
| HR (CI) | ||
|---|---|---|
| NT-proBNPAdjusted for clinical confounders | 2.38 (1.78–3.33) | |
| NT-proBNPJointly modeled with all biomarkers | 1.52 (1.15–2.08) | |
| 0.20.5125Hazard ratio (log scale) |
Risk discrimination of multimarker model (GDF-15, NT-proBNP, troponin I)
- AUC
- 0.785
Baseline characteristics · median baseline
- Median age, years
- 74
- Women
- 37%
- Median baseline GDF-15, pg/mL
- 4632
Original publication
Multimarker Analysis of Serially Measured GDF-15, NT-proBNP, ST2, GAL-3, cTnI, Creatinine, and Prognosis in Acute Heart Failure. Circ Heart Fail. Published 21 November 2022. doi:10.
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