Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients
Abstract Aims The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite‐based biomarkers that has shown to improve the diagnostic value of N terminal pro B type natriuretic peptide (NT‐proBNP). However, little is known about its usefulness in predicting outcomes. In this study, we deve...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-10-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.12928 |
| _version_ | 1819081875074842624 |
|---|---|
| author | Peter McGranaghan Hans‐Dirk Düngen Anshul Saxena Muni Rubens Joseph Salami Jasmin Radenkovic Doris Bach Svetlana Apostolovic Goran Loncar Marija Zdravkovic Elvis Tahirovic Jovan Veskovic Stefan Störk Emir Veledar Burkert Pieske Frank Edelmann Tobias Daniel Trippel |
| author_facet | Peter McGranaghan Hans‐Dirk Düngen Anshul Saxena Muni Rubens Joseph Salami Jasmin Radenkovic Doris Bach Svetlana Apostolovic Goran Loncar Marija Zdravkovic Elvis Tahirovic Jovan Veskovic Stefan Störk Emir Veledar Burkert Pieske Frank Edelmann Tobias Daniel Trippel |
| author_sort | Peter McGranaghan |
| collection | DOAJ |
| description | Abstract Aims The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite‐based biomarkers that has shown to improve the diagnostic value of N terminal pro B type natriuretic peptide (NT‐proBNP). However, little is known about its usefulness in predicting outcomes. In this study, we developed a risk score for 4‐year cardiovascular death in elderly chronic heart failure (CHF) patients using the CLP. Methods and results From the Cardiac Insufficiency Bisoprolol Study in Elderly trial, we included 280 patients with CHF aged >65 years. A targeted metabolomic analysis of the CLP biomarkers was performed on baseline serum samples. Cox regression was used to determine the association of the biomarkers with the outcome after accounting for established risk factors. A risk score ranging from 0 to 4 was calculated by counting the number of biomarkers above the cut‐offs, using Youden index. During the mean (standard deviation) follow‐up period of 50 (8) months, 35 (18%) subjects met the primary endpoint of cardiovascular death. The area under the receiver operating curve for the model based on clinical variables was 0.84, the second model with NT‐proBNP was 0.86, and the final model with the CLP was 0.90. The categorical net reclassification index was 0.25 using three risk categories: 0–60% (low), 60–85% (intermediate), and >85% (high). The continuous net reclassification index was 0.772, and the integrated discrimination index was 0.104. Conclusions In patients with CHF, incorporating a panel of three metabolite‐based biomarkers into a risk score improved the prognostic utility of NT‐proBNP by predicting long‐term cardiovascular death more precisely. This novel approach holds promise to improve clinical risk assessment in CHF patients. |
| first_indexed | 2024-12-21T20:07:43Z |
| format | Article |
| id | doaj.art-47cb22b8d6804216abd917e2f079cdec |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-21T20:07:43Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-47cb22b8d6804216abd917e2f079cdec2022-12-21T18:51:48ZengWileyESC Heart Failure2055-58222020-10-01753029303910.1002/ehf2.12928Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patientsPeter McGranaghan0Hans‐Dirk Düngen1Anshul Saxena2Muni Rubens3Joseph Salami4Jasmin Radenkovic5Doris Bach6Svetlana Apostolovic7Goran Loncar8Marija Zdravkovic9Elvis Tahirovic10Jovan Veskovic11Stefan Störk12Emir Veledar13Burkert Pieske14Frank Edelmann15Tobias Daniel Trippel16Department of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyDepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyBaptist Health South Florida Coral Gables FL USABaptist Health South Florida Coral Gables FL USABaptist Health South Florida Coral Gables FL USADepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyDepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyClinic for Cardiovascular Diseases Clinical Centre Niš, University of Niš Niš SerbiaDepartment of Cardiology Institute for Cardiovascular Diseases Dedinje Belgrade SerbiaFaculty of Medicine University of Belgrade Belgrade SerbiaDepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyDepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyComprehensive Heart Failure Center Würzburg University and University Hospital Würzburg Würzburg GermanyBaptist Health South Florida Coral Gables FL USADepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyDepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyDepartment of Internal Medicine and Cardiology Charité Campus Virchow‐Klinikum Berlin GermanyAbstract Aims The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite‐based biomarkers that has shown to improve the diagnostic value of N terminal pro B type natriuretic peptide (NT‐proBNP). However, little is known about its usefulness in predicting outcomes. In this study, we developed a risk score for 4‐year cardiovascular death in elderly chronic heart failure (CHF) patients using the CLP. Methods and results From the Cardiac Insufficiency Bisoprolol Study in Elderly trial, we included 280 patients with CHF aged >65 years. A targeted metabolomic analysis of the CLP biomarkers was performed on baseline serum samples. Cox regression was used to determine the association of the biomarkers with the outcome after accounting for established risk factors. A risk score ranging from 0 to 4 was calculated by counting the number of biomarkers above the cut‐offs, using Youden index. During the mean (standard deviation) follow‐up period of 50 (8) months, 35 (18%) subjects met the primary endpoint of cardiovascular death. The area under the receiver operating curve for the model based on clinical variables was 0.84, the second model with NT‐proBNP was 0.86, and the final model with the CLP was 0.90. The categorical net reclassification index was 0.25 using three risk categories: 0–60% (low), 60–85% (intermediate), and >85% (high). The continuous net reclassification index was 0.772, and the integrated discrimination index was 0.104. Conclusions In patients with CHF, incorporating a panel of three metabolite‐based biomarkers into a risk score improved the prognostic utility of NT‐proBNP by predicting long‐term cardiovascular death more precisely. This novel approach holds promise to improve clinical risk assessment in CHF patients.https://doi.org/10.1002/ehf2.12928MetabolomicsMetabolite profilingPrognosisBiomarkersCongestive heart failure |
| spellingShingle | Peter McGranaghan Hans‐Dirk Düngen Anshul Saxena Muni Rubens Joseph Salami Jasmin Radenkovic Doris Bach Svetlana Apostolovic Goran Loncar Marija Zdravkovic Elvis Tahirovic Jovan Veskovic Stefan Störk Emir Veledar Burkert Pieske Frank Edelmann Tobias Daniel Trippel Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients ESC Heart Failure Metabolomics Metabolite profiling Prognosis Biomarkers Congestive heart failure |
| title | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
| title_full | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
| title_fullStr | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
| title_full_unstemmed | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
| title_short | Incremental prognostic value of a novel metabolite‐based biomarker score in congestive heart failure patients |
| title_sort | incremental prognostic value of a novel metabolite based biomarker score in congestive heart failure patients |
| topic | Metabolomics Metabolite profiling Prognosis Biomarkers Congestive heart failure |
| url | https://doi.org/10.1002/ehf2.12928 |
| work_keys_str_mv | AT petermcgranaghan incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT hansdirkdungen incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT anshulsaxena incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT munirubens incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT josephsalami incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT jasminradenkovic incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT dorisbach incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT svetlanaapostolovic incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT goranloncar incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT marijazdravkovic incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT elvistahirovic incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT jovanveskovic incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT stefanstork incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT emirveledar incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT burkertpieske incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT frankedelmann incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients AT tobiasdanieltrippel incrementalprognosticvalueofanovelmetabolitebasedbiomarkerscoreincongestiveheartfailurepatients |