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Observational Study
. 2016 Dec 15:225:113-119.
doi: 10.1016/j.ijcard.2016.09.079. Epub 2016 Sep 28.

Use of serum levels of high sensitivity troponin T, galectin-3 and C-terminal propeptide of type I procollagen at long term follow-up in heart failure patients with reduced ejection fraction: Comparison with soluble AXL and BNP

M Batlle  1 , B Campos  2 , M Farrero  3 , M Cardona  3 , B González  4 , M A Castel  3 , J Ortiz  3 , E Roig  5 , M J Pulgarín  6 , J Ramírez  7 , J L Bedini  4 , M Sabaté  6 , P García de Frutos  8 , F Pérez-Villa  3
Affiliations
Observational Study

Use of serum levels of high sensitivity troponin T, galectin-3 and C-terminal propeptide of type I procollagen at long term follow-up in heart failure patients with reduced ejection fraction: Comparison with soluble AXL and BNP

M Batlle et al. Int J Cardiol. .

Abstract

Background: Prognostic biomarkers are needed to improve the management of the heart failure (HF) epidemic, being the brain natriuretic peptides the most valuable. Here we evaluate 3 biomarkers, high sensitivity troponin T (hs-TnT), galectin-3 (Gal-3) and C-terminal propeptide of type I procollagen (CICP), compare them with a recently described new candidate (sAXL), and analyze their relationship with BNP.

Methods: HF patients with reduced ejection fraction (n=192) were included in this prospective observational study, with measurements of candidate biomarkers, functional, clinical and echocardiographic variables. A Cox regression model was used to determine predictors for clinical events, i.e. all-cause mortality and heart transplantation.

Results: Hs-TnT circulating values were correlated to clinical characteristics indicative of more advanced HF. When analyzing the event-free survival at a mean follow-up of 3.6years, patients in the higher quartile of either BNP, hs-TnT, CICP and sAXL had increased risk of suffering a clinical event, but not Gal-3. Combination of high sAXL and BNP values had greater predictive value (HR 6.8) than high BNP alone (HR 4.9). In a multivariate Cox regression analysis, BNP, sAXL and NYHA class were independent risk factors for clinical events.

Conclusions: In this HF cohort, hs-TnT is a good HF marker and has a very significant prognostic value. The prognostic value of CICP and sAXL was of less significance. However, hs-TnT did not add predictive value to BNP, while sAXL did. This suggests that elevated troponin has a common origin with BNP, while sAXL could represent an independent pathological mechanism.

Keywords: AXL receptor tyrosine kinase; C-terminal propeptide of type I procollagen; Galectin-3; Heart failure; High sensitivity troponin T; Myocardial damage; Prognosis.

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