title: The multi-biomarker approach for heart failure in patients with hypertension.
abstract: We assessed the predictive ability of selected biomarkers using N-terminal pro-brain natriuretic peptide (NT-proBNP) as the benchmark and tried to establish a multi-biomarker approach to heart failure (HF) in hypertensive patients. In 120 hypertensive patients with or without overt heart failure, the incremental predictive value of the following biomarkers was investigated: Collagen III N-terminal propeptide (PIIINP), cystatin C (CysC), lipocalin-2/NGAL, syndecan-4, tumor necrosis factor-α (TNF-α), interleukin 1 receptor type I (IL1R1), galectin-3, cardiotrophin-1 (CT-1), transforming growth factor β (TGF-β) and N-terminal pro-brain natriuretic peptide (NT-proBNP). The highest discriminative value for HF was observed for NT-proBNP (area under the receiver operating characteristic curve (AUC)=0.873) and TGF-β (AUC=0.878). On the basis of ROC curve analysis we found that CT-1>152 pg/mL, TGF-β<7.7 ng/mL, syndecan>2.3 ng/mL, NT-proBNP>332.5 pg/mL, CysC>1 mg/L and NGAL>39.9 ng/mL were significant predictors of overt HF. There was only a small improvement in predictive ability of the multi-biomarker panel including the four biomarkers with the best performance in the detection of HF-NT-proBNP, TGF-β, CT-1, CysC-compared to the panel with NT-proBNP, TGF-β and CT-1 only. Biomarkers with different pathophysiological backgrounds (NT-proBNP, TGF-β, CT-1, CysC) give additive prognostic value for incident HF in hypertensive patients compared to NT-proBNP alone.
authors.affiliation: These authors contributed equally to this work.. agatbiel7@poczta.onet.pl.
authors.forename: Agata
authors.initials: A
authors.lastname: Bielecka-Dabrowa
authors.affiliation: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland. aniagluba@yahoo.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Gluba-Brzózka
authors.affiliation: These authors contributed equally to this work.. marta.zofia.michalska@umed.lodz.pl.
authors.forename: Marta
authors.initials: M
authors.lastname: Michalska-Kasiczak
authors.affiliation: Department of Nephrology, Hypertension and Family Medicine, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland. mmisztal@toya.net.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Misztal
authors.affiliation: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland. jacek.rysz@umed.lodz.pl.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
authors.affiliation: These authors contributed equally to this work.. maciejbanach@aol.co.uk.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D000209:Acute-Phase Proteins; D000368:Aged; D015415:Biomarkers / Q000097:blood; D055316:Cystatin C / Q000097:blood; D016207:Cytokines / Q000097:blood; D005260:Female; D037502:Galectin 3 / Q000097:blood; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D011498:Protein Precursors / Q000097:blood; D011518:Proto-Oncogene Proteins / Q000097:blood; D053573:Receptors, Interleukin-1 Type I / Q000097:blood; D053671:Syndecan-4 / Q000097:blood; D016212:Transforming Growth Factor beta / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; D016207:Cytokines; D037502:Galectin 3; C508590:IL1R1 protein, human; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D010446:Peptide Fragments; D011347:Procollagen; D011498:Protein Precursors; D011518:Proto-Oncogene Proteins; D053573:Receptors, Interleukin-1 Type I; D053671:Syndecan-4; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; C063382:prepro-brain natriuretic peptide; C041876:procollagen Type III-N-terminal peptide; D020097:Natriuretic Peptide, Brain; C092073:cardiotrophin 1
keywords: biomarkers; heart failure; hypertension