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A A Skvortsov1, O Yu Narusov, M D Muksinova

  • 1FSBO National Medical research center of cardiology of the Ministry of healthcare of the Russian Federation. fake@neicon.ru.

Kardiologiia
|January 10, 2019
PubMed
Summary
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Monitoring N-terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble suppression of tumorigenicity 2 (sST2) effectively predicts outcomes in heart failure patients. Lowering NT-proBNP and sST2 levels significantly reduces cardiovascular events and improves patient status.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Heart Failure Management

Background:

  • Acute decompensated heart failure (ADHF) requires effective long-term monitoring strategies.
  • Modern biomarkers offer potential for evaluating treatment efficacy in post-ADHF patients.

Purpose of the Study:

  • To assess the efficacy of monitoring modern biomarker concentrations for long-term treatment in patients post-ADHF.
  • To evaluate the correlation between biomarker changes and clinical outcomes.

Main Methods:

  • 100 severe decompensated heart failure patients were stratified by NT-proBNP levels at discharge.
  • High-risk patients were randomized to NT-proBNP monitoring (NPM) or standard therapy.
  • Concentrations of NT-proBNP, sST2, copeptin, NCAL, galectin 3, and troponin T were measured at baseline, 3, and 6 months.

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Main Results:

  • Changes in NT-proBNP, copeptin, and sST2 strongly correlated with clinical status, functional capacity, and echocardiographic parameters.
  • NPM group patients achieving NT-proBNP reduction (<988.5 pg/ml or ≥50% baseline) had the lowest adverse event risk.
  • Reduced sST2 (<30 ng/ml or >24.9% decrease) also significantly lowered cardiovascular event risk.

Conclusions:

  • NT-proBNP, sST2, and copeptin changes accurately reflect clinical status in long-term HF monitoring.
  • Achieving specific NT-proBNP reduction targets post-ADHF is associated with reduced adverse outcomes.
  • sST2 reduction targets are crucial for mitigating cardiovascular event risk in post-ADHF patients.