Key result
Top quartile beta-CTx levels were associated with increased risk of cardiovascular death or heart failure versus the lowest quartile in non-ST-elevation ACS (10.9% vs 3.8%; HR 2.22, 95% CI 1.50-3.27).
Why the study?
Small studies suggested an association between markers of collagen turnover and adverse outcomes in HF, but the prognostic value of beta-CTx in non-ST-elevation acute coronary syndrome remained to be evaluated.
Is elevated baseline beta-CTx associated with an increased risk of cardiovascular death or new or worsening heart failure in patients with non-ST-elevation acute coronary syndrome?
Cohort (n=4,094)
Is elevated baseline beta-CTx associated with an increased risk of cardiovascular death or new or worsening heart failure in patients with non-ST-elevation acute coronary syndrome?
Hazard Ratio: 2.22 (95% CI 1.5–3.27)
Absolute Event Rate: 10.9% vs 3.8%
p-value: p=<0.001
Elevated levels of the collagen turnover biomarker beta-CTx are independently associated with an increased risk of cardiovascular death and heart failure in patients with non-ST-elevation acute coronary syndrome, providing complementary prognostic information to traditional biomarkers.
Background Small studies have suggested an association between markers of collagen turnover and adverse outcomes in heart failure ( HF ). We examined C-terminal telopeptide (beta- CT x) and the risk of cardiovascular death or new or worsening HF in non- ST -elevation acute coronary syndrome. Methods and Results We measured baseline serum beta- CT x, NT -pro BNP (N-terminal pro-B-type natriuretic peptide), hsTnT (high-sensitivity cardiac troponin T) and hs CRP (high-sensitivity C-reactive protein) (Roche Diagnostics) in a nested biomarker analysis (n=4094) from a study of patients with non- ST -elevation acute coronary syndrome. The relationship between quartiles of beta- CT x and cardiovascular death or HF over a median follow-up time of 12 months was analyzed using adjusted Cox models. Higher beta- CT x levels identified a significantly higher risk of cardiovascular death/ HF (Q4 10.9% versus Q1 3.8%, Logrank P<0.001). After multivariable adjustment, beta- CT x in the top quartile (Q4) was associated with cardiovascular death/ HF (Q4 versus Q1: adjusted hazard ratio 2.22 [1.50-3.27]) and its components (Q4 versus Q1: cardiovascular death: adjusted hazard ratio 2.48 [1.46-4.21]; HF : adjusted hazard ratio 2.04 [1.26-3.30]). In an adjusted multimarker model including NT -pro BNP , hsTnT, and hs CRP , beta- CT x remained independently associated with cardiovascular death/ HF (Q4 versus Q1: adjusted hazard ratio 1.98 [1.34-2.93]) and its components. Beta- CT x correlated weakly with NT -pro BNP ( r=0.17, P<0.001) and left ventricular ejection fraction ( r=-0.05, P=0.008) and did not correlate with hsTnT ( r=0.02, P=0.20), or hs CRP ( r=-0.03, P=0.09). Conclusions Levels of beta- CT x, a biomarker of collagen turnover, were associated with cardiovascular death and HF in patients with non- ST -elevation acute coronary syndrome. This biomarker, which correlated only weakly or not significantly with traditional biomarkers of cardiovascular death and HF , may provide complementary pathobiological insight and risk stratification in these patients.
No takes yet. Share an insight, caveat, or question.
Zelniker et al. (2019) conducted a cohort in non-ST-elevation acute coronary syndrome (n=4,094). Top quartile beta-CTx levels vs. Lowest quartile beta-CTx levels was evaluated on cardiovascular death or new or worsening HF (HR 2.22, 95% CI 1.50-3.27, p=<0.001). Top quartile beta-CTx levels were associated with increased risk of cardiovascular death or heart failure versus the lowest quartile in non-ST-elevation ACS (10.9% vs 3.8%; HR 2.22, 95% CI 1.50-3.27).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: