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Personalized treatment of heart failure with biomarker guidance using a novel disease severity score
Anupama Vasudevan1, Hourossadat Hashemi Jazi1, Jane I Won1
1Baylor Heart and Vascular Institute, Dallas, Texas (Vasudevan, Won); Texas A&M Health Science Center College of Medicine, Dallas Campus, Dallas, Texas (Vasudevan, Won, McCullough); Baylor Research Institute, Dallas, Texas (Vasudevan, Won); Baylor University Medical Center, Dallas, Texas (Jazi, Ball, Patankar, Sarmast, McCullough); Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas (Ball, Won, Patankar, Sarmast, McCullough); Division of Aging, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts (Shin); Division of Cardiology, Department of Medicine, VA Boston Health Care System, Boston, Massachusetts (Shin); and The Heart Hospital Baylor Plano, Plano, Texas (McCullough).
Abstract:
We propose a novel Myocardial Injury Summary Score (MISS) integrating the 4 biomarkers suggested by the 2013 American College of Cardiology/American Heart Association guidelines for management of heart failure. In this case series, we examined 4 heart failure patients who received treatment guided by the biomarker results and 4 patients who received routine clinical management with no information about the biomarkers. Most of the patients receiving biomarker-guided management had medications adjusted based on the biomarker values, while no changes were recommended for patients in the biomarker-blinded category. This case series suggests that biomarker-guided therapy with serial biomarker values leads to timely therapeutic adjustment and that biomarker values as a composite score can be used effectively to measure the severity of heart failure.