Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure
Permanent lenke
https://hdl.handle.net/10037/27139Dato
2022-05-05Type
Journal articleTidsskriftartikkel
Peer reviewed
Forfatter
Vergaro, Giuseppe; Gentile, Francesco; Aimo, Alberto; Januzzi, James L.; Richards, A. Mark; Lam, Carolyn S.P.; de Boer, Rudolf A.; Meems, Laura M.G.; Latini, Roberto; Staszewsky, Lidia; Anand, Inder S.; Cohn, Jay N.; Ueland, Thor; Gullestad, Lars; Aukrust, Pål; Brunner-La Rocca, Hans-Peter; Bayes-Genis, Antoni; Lupón, Josep; Yoshihisa, Akiomi; Takeishi, Yasuchika; Egstrup, Michael; Gustafsson, Ida; Gaggin, Hanna K.; Eggers, Kai M.; Huber, Kurt; Gamble, Greg D.; Ling, Lieng H.; Leong, Kui Toh Gerard; Yeo, Poh Shuah Daniel; Ong, Hean Yee; Jaufeerally, Fazlur; Ng, Tze P.; Troughton, Richard; Doughty, Robert N.; Devlin, Gerry; Lund, Mayanna; Giannoni, Alberto; Passino, Claudio; Emdin, MicheleSammendrag
Methods and results Individual data of patients from the Biomarkers In Heart Failure Outpatient Study (BIOS) Consortium with sST2, hs-cTnT, and NT-proBNP measured were analysed. The primary endpoint was a composite of 1 year cardiovascular death and HF hospitalization. The secondary endpoints were 5 year cardiovascular and all-cause death. The cohort included 4540 patients (age 67 ± 12 years, left ventricular ejection fraction 33 ± 13%, 1111 women, 25%). Women showed lower sST2 (24 vs. 27 ng/mL, P < 0.001) and hs-cTnT level (15 vs. 20 ng/L, P < 0.001), and similar concentrations of NT-proBNP (1540 vs. 1505 ng/L, P = 0.408). Although the three biomarkers were confirmed as independent predictors of outcome in both sexes, the optimal prognostic cut-off was lower in women for sST2 (28 vs. 31 ng/mL) and hs-cTnT (22 vs. 25 ng/L), while NT-proBNP cut-off was higher in women (2339 ng/L vs. 2145 ng/L). The use of sex-specific cut-offs improved risk prediction compared with the use of previously standardized prognostic cut-offs and allowed to reclassify the risk of many patients, to a greater extent in women than men, and for hs-cTnT than sST2 or NT-proBNP. Specifically, up to 18% men and up to 57% women were reclassified, by using the sex-specific cut-off of hs-cTnT for the endpoint of 5 year cardiovascular death.
Conclusions In patients with chronic HF, concentrations of sST2 and hs-cTnT, but not of NT-proBNP, are lower in women. Lower sST2 and hs-cTnT and higher NT-proBNP cut-offs for risk stratification could be used in women.