Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort

Gürgöze, MT; Akkerhuis, KM; Oemrawsingh, RM; Umans, VAWM; Kietselaer, B; Schotborgh, CE; Ronner, E; Lenderink, T; Aksoy, I; van der Harst, P; Asselbergs, FW; Maas, AC; Oude Ophuis, AJ; Krenning, B; de Winter, RJ; The, SHK; Wardeh, AJ; Hermans, WRM; Cramer, GE; van Gorp, I; de Rijke, YB; van Schaik, RHN; Boersma, E

doi:10.1093/ehjacc/zuad042

Coronary disease & ACS

Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort

Eur Heart J Acute Cardiovasc CarePublished 25 Apr 2023Prospective cohort study

Read the original article ↗PubMed

Cite

Authors' conclusion

Longitudinally measured hs-cTnT and GDF-15 concentrations provide prognostic value in the risk assessment of clinically stabilized patients post-ACS.

Study context

Population: Post-ACS patients, real-world cohort (median age 63 years, 78% men)12,218 blood samples
Participants: 844 patients

Exposure: Serially measured high-sensitivity cardiac troponin T (hs-cTnT), NT-proBNP, high-sensitivity C-reactive protein (hs-CRP) and GDF-15 in relation to CV mortality and recurrent ACS
Outcome: CV mortality and recurrent ACS
Follow-up: 1-year follow-up

Methodological detailsmulticentre, observational, serial biomarker measurements, multivariable joint models, Median 17 blood samples per patient during 1-year follow-up

Multicentre
Observational
Serial biomarker measurements
Multivariable joint models
Median 17 blood samples per patient during 1-year follow-up

Main finding

As reported in the abstract

Primary endpoint (CV mortality and recurrent ACS), per 1 SD increase in log biomarker

Hazard ratio (95% CI)P value

log[hs-cTnT] per 1 SD increaseadjusted for 6-month post-discharge GRACE score; 61% increased risk

1.61(1.02–2.44)

P = 0.045

log[GDF-15] per 1 SD increaseadjusted for 6-month post-discharge GRACE score; 81% increased risk

1.81(1.28–2.70)

P = 0.001

Per 1 SD increase, as printed

Primary endpoint (PE) reached: 45 patients

Observational data: associations, not effects.

Further findings

GDF-15 trajectory before the PE

GDF-15 level showed an increasing trend prior to the PE

Reference

Authors: Gürgöze MT, Akkerhuis KM, Oemrawsingh RM, Umans VAWM, Kietselaer B, Schotborgh CE, et al.
All 23 authors
Gürgöze MT, Akkerhuis KM, Oemrawsingh RM, Umans VAWM, Kietselaer B, Schotborgh CE, Ronner E, Lenderink T, Aksoy I, van der Harst P, Asselbergs FW, Maas AC, Oude Ophuis AJ, Krenning B, de Winter RJ, The SHK, Wardeh AJ, Hermans WRM, Cramer GE, van Gorp I, de Rijke YB, van Schaik RHN, Boersma E
Journal: European Heart Journal – Acute Cardiovascular Care
Published: 25 Apr 2023
DOI: 10.1093/ehjacc/zuad042
PubMed: 37096818
Registration: NTR1698; NTR1106

Topic: Coronary disease & ACS

Key notes

Average biomarker levels systematically higher in PE than PE-free patients
hs-cTnT and GDF-15 associations remained significant after multivariable adjustment; NT-proBNP and hs-CRP not significant

Original publication

Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort. Eur Heart J Acute Cardiovasc Care. Published 25 April 2023. doi:10.1093/ehjacc/zuad042

Read the original article ↗

Summarised from the published abstract; every number is checked against it