• NEWS . 09 Mar 2020
  • Combining novel biomarkers improves risk prediction of cardiovascular mortality in STEMI patients

  • In patients with ST-elevation myocardial infarction (STEMI), novel biomarkers ST2 and Pentraxin-3 (Ptx-3) are associated with the incidence of cardiovascular mortality (CV-mortality), in addition to the classic biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP).

    In this study, researchers sought to investigate the effects of multimarker approaches in estimating the prognosis of STEMI patients. A total of 147 patients with STEMI were enrolled, and their NT-proBNP and serum levels of ST2 and Ptx-3 evaluated. Results from the 2-year follow-up period (743.2±61.2 days) were correlated with CV-mortality risk.

    NT-proBNP (hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.21–2.21; p=0.001) and ST2 (HR, 1.000022; 95% CI, 1.00–1.001; p<0.001) were demonstrated to be reliable predictors of CV-mortality; however, the highest predictive power was seen with Ptx-3 (HR, 3.1; 95% CI, 1.63—5.39; p<0.001). When two biomarkers were combined in a multivariate Cox regression model, the only biomarker combination that showed relevant improvement of risk assessment was NT-proBNP + Ptx-3 (Akaike information criterion [AIC]=209, Schwarz information criterion [BIC]=214, p=0.001, measure of explained randomness [MER]=0.75, measure of explained variation [MEV]=0.64). On the other hand, a three-marker approach of NT-proBNP + ST2 + Ptx-3 (AIC=208, BIC=214, p<0.001, MER=0.77, MEV=0.66) showed the highest accuracy in estimating cardiac risk. Altogether, these findings indicate that multimarker approaches offer the benefit of enhanced accuracy in the prediction of CV-mortality.

    Reference:
    Zagidullin N, et al. Combining novel biomarkers for risk stratification of two-year cardiovascular mortality in patients with ST-elevation myocardial infarction. J Clin Med 2020;9. pii: E550.