Combining collagen biomarkers with clinical, biochemical, and echocardiographic parameters predicted cardiovascular outcomes in outpatients with new-onset heart failure symptoms (AUC ROC 0.806, P<0.001).
Observational (n=172)
Can collagen turnover biomarkers (MMP2, MMP9, TIMP1) combined with clinical and echocardiographic parameters predict cardiovascular outcomes in outpatients with new-onset heart failure symptoms?
The addition of biomarkers, specifically MMP2 and high-sensitivity troponin I, to clinical and echocardiographic variables improves the prediction of cardiovascular prognosis in outpatients with new-onset heart failure symptoms.
Effect estimate: AUC ROC 0.806
p-value: p=< 0.001
BACKGROUND: Prognosis of heart failure patients has been defined in hospital-based or retrospective studies. This study aimed to characterize prognosis of outpatients with new-onset preserved or reduced ejection fraction heart failure; to explore the role of collagen turnover biomarkers (MMP2, MMP9, TIMP1) in predicting prognosis; and to analyse their relationship with echocardiographic parameters and final diagnosis. METHODS: This is an observational, prospective, longitudinal study. Outpatients with new-onset heart failure symptoms referred to a one-stop clinic were included. Echocardiography and biomarkers plasma levels determination were performed at the inclusion. A prospective follow-up was conducted to report cardiovascular events. The discriminant analysis was applied to identify the parameters related to cardiovascular outcomes. RESULTS: A total of 172 patients (75 ± 9 years) were included, 67% with heart failure (64% preserved and 36% with reduced ejection fraction). During follow-up (median 34.5 months), 32.6% had at least one cardiovascular event and 9.9% died. Heart failure groups showed no differences in cardiovascular outcomes with a higher rate of events than nonheart failure patients. MMP2 and TIMP1 were correlated with diastolic dysfunction (Rho 0.349 and 0.294, P < 0.001). In the discriminant analysis, the combination of biomarkers with clinical, biochemical and echocardiographic parameters was useful to predict cardiovascular outcomes (AUC ROC 0.806, Wilks lambda 0.7688, P < 0.001). CONCLUSIONS: Prognosis of outpatients with new-onset heart failure symptoms is comparable between heart failure with preserved or reduced subgroups. The addition of biomarkers specially MMP2 and high sensitive troponin I to other clinical, biochemical and echocardiographic variables can predict cardiovascular prognosis at the time of diagnosis.
Sanchís et al. (2015) conducted an observational in New-onset heart failure symptoms (n=172). Collagen turnover biomarkers (MMP2, MMP9, TIMP1) was evaluated on Cardiovascular outcomes (AUC ROC 0.806, p=< 0.001). Combining collagen biomarkers with clinical, biochemical, and echocardiographic parameters predicted cardiovascular outcomes in outpatients with new-onset heart failure symptoms (AUC ROC 0.806, P<0.001).