Author + information
- Tariq Ahmad,
- Mona Fiuzat,
- Ben Neely,
- Megan Neely,
- Kirkwood Adams,
- David Whellan,
- Mark Donahue,
- Dalane Kitzman,
- Ileana Pina,
- Faiez Zannad,
- William Kraus,
- Christopher O'Connor and
- G. Michael Felker
Elevations in NTproBNP, hsCRP, and cTnT are associated with increased risk of adverse outcomes in patients with chronic HF. The effect of exercise training on these markers and the association of changes in biomarkers with outcomes has not been well studied.
NTproBNP, hsCRP, and cTnT levels were assessed at baseline and 3 months in a cohort of 928 subjects from the HF-ACTION study, a randomized clinical trial of exercise training in chronic HF patients with reduced ejection fraction (< 35%). NTproBNP and hsCRP were log-transformed to approximate normality; cTnT was modeled as detectable (≥ 0.01 ng/ml) vs. undetectable (< 0.01 ng/ml). Linear and logistic regression were used to assess 3 month levels as a function of baseline value and treatment assignment (exercise training vs. not). Cox proportional hazard modeling was used to evaluate the relationship between biomarker changes and long term outcomes.
Exercise training was not associated with improvements in levels of NTproBNP (P=0.10), hs-CRP (P=0.80) or lower risk of detectable cTnT levels (P=0.83) at 3 months. Improvements in NTproBNP, but not hsCRP or cTnT, were associated with improved peak VO2 (P<0.001) and decreased risk of all outcomes, after adjustment for risk factors (Table 1).
Exercise training did not appear to improve biomarkers of myocardial stress, injury, or inflammation at 3 months. Decreases in NTproBNP, but not hsCRP and cTnT, were associated with improvements in peak VO2 and clinical outcomes.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: New Paradigms in Prognostic Role of Biomarkers in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1265-311
- 2013 American College of Cardiology Foundation