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Troponin-I levels as a potential prognostic biomarker of sacubitril/valsartan treatment response in heart failure with reduced ejection fraction: Who will benefit most?
Clin Cardiol. 2018 Oct 15;:
Authors: Nakou ES, Marketou ME, Chlouverakis GI, Patrianakos AP, Vardas PE, Parthenakis FI
Abstract
BACKGROUND: Despite robust data on the benefits of sacubitril/ valsartan (LCZ696) in patients with chronic heart failure with reduced ejection fraction (HFrEF), there is no evidence yet on prespecified predictive markers of its efficacy.
HYPOTHESIS: The objective of this study was to identify potentially prognostic factors of LCZ696 treatment response.
METHODS: We included 48 symptomatic patients with chronic HFrEF (LVEF ≤ 35%) and New York Heart Association (NYHA) class II/III: Group A (N =23) received LCZ696 (105 ± 30 mg twice daily), whereas it was not prescribed in group B (N = 25) according to physician's judgement. Analysis of biochemical parameters, cardiopulmonary exercise testing and echocardiographic evaluation were performed at baseline and 6 months later.
RESULTS: The baseline serum troponin-I levels (TnI) and peak oxygen uptake (VO2 max) were positively associated with the increase in VO2 max (ΔVO2 max = +14.11%, p < 0.05 vs group B) after sacubitril/valsartan treatment (r = 0.68, p = 0.001 and r = 0.57, p = 0.004 respectively). Positive correlations were reported between ΔVO2 max and the improvements in the ratio of early diastolic filling to myocardial tissue velocity (ΔE/E') and the tricuspid annular peak systolic velocity (ΔSa) in group A, (r= 0.58, p = 0.004 and r= 0.60, p = 0.002 respectively). In multiple regression analysis ΔVO2 max was correlated significantly with TnI (beta = 0.35, p = 0.048), ΔE/E' (beta = 0.36, p = 0.031) and ΔSa (beta = 0.37, p = 0.035).
CONCLUSIONS: Troponin-I levels may be an independent predictive marker of sacubitril/valsartan efficacy in HFrEF. This article is protected by copyright. All rights reserved.
PMID: 30324615 [PubMed - as supplied by publisher]