Abstract | BACKGROUND: METHODS:
Biomarker measurements and clinical data were obtained from 2,017 adults with group 1 PAH. Associations among biomarker levels and clinical variables, including survival times, were examined with multivariable regression models. Likelihood ratio tests and the Akaike information criterion were used to compare survival models. RESULTS: Higher ST2 and NT-proBNP were associated with higher pulmonary pressures and vascular resistance and lower 6-min walk distance. Higher ST2 and NT-proBNP levels were associated with increased risk of death (hazard ratios: 2.79; 95% CI, 2.21-3.53; P < .001 and 1.84; 95% CI, 1.62-2.10; P < .001, respectively). The addition of ST2 to survival models composed of other predictors of survival, including NT-proBNP, significantly improved model fit and predictive capacity. CONCLUSIONS: ST2 and NT-proBNP are strong, noninvasive prognostic biomarkers in PAH. Despite its prognostic value in left-sided heart failure, Gal3 was not predictive in PAH. Adding ST2 to survival models significantly improves model predictive capacity. Future studies are needed to develop multimarker assays that improve noninvasive risk stratification in PAH.
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Authors | Catherine E Simpson, Rachel L Damico, Paul M Hassoun, Lisa J Martin, Jun Yang, Melanie K Nies, R Dhananjay Vaidya, Stephanie Brandal, Michael W Pauciulo, Eric D Austin, D Dunbar Ivy, William C Nichols, Allen D Everett |
Journal | Chest
(Chest)
Vol. 157
Issue 6
Pg. 1606-1616
(06 2020)
ISSN: 1931-3543 [Electronic] United States |
PMID | 31987881
(Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Biomarkers
- IL1RL1 protein, human
- Interleukin-1 Receptor-Like 1 Protein
- Peptide Fragments
- Protein Precursors
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
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Topics |
- Biomarkers
(blood)
- Enzyme-Linked Immunosorbent Assay
- Female
- Heart Failure
(blood, complications, physiopathology)
- Humans
- Interleukin-1 Receptor-Like 1 Protein
(blood)
- Male
- Middle Aged
- Natriuretic Peptide, Brain
(blood)
- Peptide Fragments
(blood)
- Prognosis
- Protein Precursors
- Pulmonary Arterial Hypertension
(blood, etiology, mortality)
- Risk Factors
- Stroke Volume
(physiology)
- Survival Rate
(trends)
- United States
(epidemiology)
- Ventricular Function, Left
(physiology)
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