https://doi.org/10.55788/d729239d
Better imaging techniques and biomarkers are needed to assess congestion in HF. The protein bio-ADM has a prominent role in maintaining a barrier function of the vascular endothelium and is a promising marker for residual congestion. Mr Geert Voordes (University Medical Center Groningen, the Netherlands) and colleagues evaluated bio-ADM as a marker for residual congestion and early re-hospitalisation in patients with acute HF [1].
Bio-ADM and NT-proBNP were measured in 1,005 baseline samples collected for the STRONG-HF trial. Participants were divided into tertiles (n=335 patients each) according to concentrations of both biomarkers: low bio-ADM (<13.32 pg/mL), medium bio-ADM (13.32–28.40 pg/mL), and high bio-ADM (>28.40 pg/mL); low NT-proBNP (<2,159 ng/L), medium NT-proBNP (2,160–4,165 ng/L), and high NT-proBNP (>4,165 ng/L).
Bio-ADM and NT-proBNP were linked to different signs and symptoms of HF. Elevated bio-ADM was associated primarily with oedema and orthopnoea, whereas elevated NT-proBNP was more associated with the presence of rales. There was no benefit of bio-ADM over NT-proBNP in predicting decongestion at day 90. There was no difference in bio-ADM levels at baseline and after 90 days (P=0.2689); however, there was a reduction in NT-proBNP levels between these time points. The prognostic value of bio-ADM was very limited (area under the curve 0.5963; 95% CI 0.5546–0.6380). The prognostic value of both markers combined was equally limited: area under the curve 0.6078 (95% CI 0.5666–0.6490). The tertile with the highest bio-ADM had the worst prognosis for HF hospitalisation (HR 2.33) and for all‐cause mortality or HF hospitalisation combined (HR 2.14). There was a modest trend towards significance (P=0.0588) for both markers combined (vs NT-proBNP alone) for the combined outcome of all‐cause mortality or HF hospitalisation. Baseline bio-ADM levels did not affect the treatment effect of high-intensity care.
- Voordes GHD, et al. Bio-ADM as a marker for residual congestion and early rehospitalization in patients hospitalized for acute heart failure; data from STRONG-HF. Late-breaking clinical trials II, Heart Failure 2024, 11–14 May, Lisbon, Portugal.
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Table of Contents: HFA 2024
Featured articles
Meet the Trialist: Innovating cardiac monitoring with MONITOR-HF
Trials: Pharmacology
Effects of semaglutide on MACE irrespective of HF status
SEQUOIA-HCM: Aficamten demonstrates clinical efficacy in obstructive HCM
ARIES-HM3 trial: Subgroup analysis in patients with prior need for aspirin
Three diuretic regimens compared in the DEA-HF study
Adding a mineralocorticoid receptor modulator in heart failure with CKD
SGLT2 Inhibitors
Empagliflozin did not reduce mortality for HF after MI regardless of T2D status
SGLT2 inhibitors decrease atrial fibrillation risk in patients with HFrEF
SGLT2 inhibition: Major and early impact on heart failure hospitalisation risk
Trials: Other
Individualised diuretic titration in acute HF without a physician
Intravenous iron deficiency treatment improves exercise capacity in patients with HFpEF
CD34+ stem cells promote reverse cardiac remodelling after acute MI
Registries
Sex-specific outcomes and resource utilisation after HF hospitalisation
Application of guideline-directed medical therapy in patients with HFrEF in the Netherlands
Devices
PAP-guided management system appears safe in patients with HF
Delivery of CRT guided by non-invasive anatomy assessment
RELIEVE-ing HFrEF with interatrial shunting
Miscellaneous
Algorithm-based remote patient monitoring was associated with lower mortality in a retrospective cohort study
High mortality and morbidity in suspected de novo HF in outpatient care
Bio-ADM as a marker for congestion in patients hospitalised for acute HF
Hypertonic saline not effective in ambulatory patients with heart failure?
No effect of low-dose carperitide on mortality or hospitalisation in acute HF
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