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Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide, Troponin-T, and Growth-Differentiation Factor 15 in
Vivan J M Baggen1, Annemien E van den Bosch1, Jannet A Eindhoven1
1From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.).
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a strong predictor of cardiovascular events in adult congenital heart disease (ACHD) patients. Elevated NT-proBNP, high-sensitive troponin-T, and growth-differentiation factor 15 identify high-risk individuals.
Area of Science:
- Cardiology
- Biomarker Research
- Adult Congenital Heart Disease
Background:
- Increasing prevalence of adult congenital heart disease (ACHD) necessitates improved risk stratification.
- Current prognostic tools for ACHD are insufficient, lacking established biomarkers.
- This study investigates NT-proBNP, high-sensitive troponin-T, and GDF-15 as prognostic markers in ACHD.
Purpose of the Study:
- To assess the prognostic value of NT-proBNP, high-sensitive troponin-T, and GDF-15 for cardiovascular events in ACHD patients.
- To determine if these biomarkers can identify high-risk individuals within the ACHD population.
Main Methods:
- Prospective follow-up of 595 clinically stable ACHD patients.
- Measurement of NT-proBNP, high-sensitive troponin-T, and GDF-15 at baseline.
- Kaplan-Meier survival analysis and Cox regression to evaluate biomarker association with cardiovascular events.
Main Results:
- NT-proBNP in the upper quartile significantly predicted cardiovascular events (aHR 9.05) and death/heart failure (aHR 16.0).
- Low NT-proBNP levels (<2 quartiles) were associated with a very low risk of death and heart failure (1%).
- Elevated levels of all three biomarkers identified patients at the highest risk of cardiovascular events.
Conclusions:
- NT-proBNP offers significant prognostic information in ACHD, exceeding conventional risk models.
- NT-proBNP can reliably exclude the risk of death and heart failure in ACHD patients.
- These biomarkers are valuable tools for monitoring and managing cardiovascular risk in ACHD.
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