Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysis
Abstract Aims Hypertrophic cardiomyopathy (HCM) is the most prevalent monogenic heart disease. HCM is an important cause of sudden cardiac death and may also lead to outflow tract obstruction and heart failure. Disease severity is highly variable and risk stratification remains limited. Therefore, w...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14073 |
| _version_ | 1797794276731518976 |
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| author | Mark Jansen Sila Algül Laurens P. Bosman Michelle Michels Jolanda van derVelden Rudolf A. deBoer J. Peter vanTintelen Folkert W. Asselbergs Annette F. Baas |
| author_facet | Mark Jansen Sila Algül Laurens P. Bosman Michelle Michels Jolanda van derVelden Rudolf A. deBoer J. Peter vanTintelen Folkert W. Asselbergs Annette F. Baas |
| author_sort | Mark Jansen |
| collection | DOAJ |
| description | Abstract Aims Hypertrophic cardiomyopathy (HCM) is the most prevalent monogenic heart disease. HCM is an important cause of sudden cardiac death and may also lead to outflow tract obstruction and heart failure. Disease severity is highly variable and risk stratification remains limited. Therefore, we aimed to review current knowledge of prognostic blood‐based biomarkers in HCM. Methods and results A systematic literature search was performed on PubMed, Embase, and the Cochrane library to identify studies assessing plasma or serum biomarkers for outcomes involving malignant ventricular arrhythmia, outflow tract obstruction, and heart failure. Risk of bias was assessed using the QUIPS tool. Meta‐analyses were performed using the random effects method. A total of 26 unique cohort studies assessing 42 biomarkers were identified. Overall risk of bias was moderate. Thirty‐two biomarkers were significantly associated to an HCM outcome in at least one study (nine biomarkers in at least two studies). In pooled analyses, cardiovascular mortality was predicted by N‐terminal prohormone of brain natriuretic peptide (hazard ratio [HR] 5.38 per log[pg/mL], 95% confidence interval [CI] 2.07–14.03, P < 0.001, I2 = 0%) and high‐sensitivity C‐reactive protein (HR 1.30 per μg/mL, 95% CI 1.00–1.68, P = 0.05, I2 = 78%), all‐cause mortality by low‐density lipoprotein cholesterol (HR 0.63 per μmol/mL, 95% CI 0.49–0.80, P < 0.001, I2 = 0%), and a combined congestive heart failure, malignant ventricular arrhythmia, and stroke outcome by high‐sensitivity cardiac troponin T (pooled HR 4.19 for ≥0.014 ng/mL, 95% CI 2.22–7.88, P < 0.001, I2 = 0%). Quality of evidence was low–moderate. Conclusions Several blood‐based biomarkers were identified as predictors of HCM outcomes. Additional studies are required to validate their prognostic utility within current risk stratification models. |
| first_indexed | 2024-03-13T03:00:23Z |
| format | Article |
| id | doaj.art-3d00034d775d4521800ec77de51f9351 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-13T03:00:23Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-3d00034d775d4521800ec77de51f93512023-06-27T14:49:57ZengWileyESC Heart Failure2055-58222022-10-01953418343410.1002/ehf2.14073Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysisMark Jansen0Sila Algül1Laurens P. Bosman2Michelle Michels3Jolanda van derVelden4Rudolf A. deBoer5J. Peter vanTintelen6Folkert W. Asselbergs7Annette F. Baas8Department of Genetics, University Medical Center Utrecht Utrecht University Utrecht The NetherlandsDepartment of Physiology, Amsterdam Cardiovascular Sciences Amsterdam University Medical Center, Vrije Universiteit Amsterdam Amsterdam The NetherlandsNetherlands Heart Institute Utrecht The NetherlandsDepartment of Cardiology Thoraxcenter, Erasmus University Medical Center, Erasmus University Rotterdam The NetherlandsDepartment of Physiology, Amsterdam Cardiovascular Sciences Amsterdam University Medical Center, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Genetics, University Medical Center Utrecht Utrecht University Utrecht The NetherlandsNetherlands Heart Institute Utrecht The NetherlandsDepartment of Genetics, University Medical Center Utrecht Utrecht University Utrecht The NetherlandsAbstract Aims Hypertrophic cardiomyopathy (HCM) is the most prevalent monogenic heart disease. HCM is an important cause of sudden cardiac death and may also lead to outflow tract obstruction and heart failure. Disease severity is highly variable and risk stratification remains limited. Therefore, we aimed to review current knowledge of prognostic blood‐based biomarkers in HCM. Methods and results A systematic literature search was performed on PubMed, Embase, and the Cochrane library to identify studies assessing plasma or serum biomarkers for outcomes involving malignant ventricular arrhythmia, outflow tract obstruction, and heart failure. Risk of bias was assessed using the QUIPS tool. Meta‐analyses were performed using the random effects method. A total of 26 unique cohort studies assessing 42 biomarkers were identified. Overall risk of bias was moderate. Thirty‐two biomarkers were significantly associated to an HCM outcome in at least one study (nine biomarkers in at least two studies). In pooled analyses, cardiovascular mortality was predicted by N‐terminal prohormone of brain natriuretic peptide (hazard ratio [HR] 5.38 per log[pg/mL], 95% confidence interval [CI] 2.07–14.03, P < 0.001, I2 = 0%) and high‐sensitivity C‐reactive protein (HR 1.30 per μg/mL, 95% CI 1.00–1.68, P = 0.05, I2 = 78%), all‐cause mortality by low‐density lipoprotein cholesterol (HR 0.63 per μmol/mL, 95% CI 0.49–0.80, P < 0.001, I2 = 0%), and a combined congestive heart failure, malignant ventricular arrhythmia, and stroke outcome by high‐sensitivity cardiac troponin T (pooled HR 4.19 for ≥0.014 ng/mL, 95% CI 2.22–7.88, P < 0.001, I2 = 0%). Quality of evidence was low–moderate. Conclusions Several blood‐based biomarkers were identified as predictors of HCM outcomes. Additional studies are required to validate their prognostic utility within current risk stratification models.https://doi.org/10.1002/ehf2.14073Hypertrophic cardiomyopathyPrognosisHeart failureSudden cardiac deathBiomarkerSystematic review |
| spellingShingle | Mark Jansen Sila Algül Laurens P. Bosman Michelle Michels Jolanda van derVelden Rudolf A. deBoer J. Peter vanTintelen Folkert W. Asselbergs Annette F. Baas Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysis ESC Heart Failure Hypertrophic cardiomyopathy Prognosis Heart failure Sudden cardiac death Biomarker Systematic review |
| title | Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysis |
| title_full | Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysis |
| title_fullStr | Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysis |
| title_full_unstemmed | Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysis |
| title_short | Blood‐based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta‐analysis |
| title_sort | blood based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis a systematic review and meta analysis |
| topic | Hypertrophic cardiomyopathy Prognosis Heart failure Sudden cardiac death Biomarker Systematic review |
| url | https://doi.org/10.1002/ehf2.14073 |
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