Biomarkers in ACS and Heart Failure: Should Men and Women Be Interpreted Differently?

Motiwala, Shweta R.; Sarma, Amy; Januzzi, James L.; O’Donoghue, Michelle L.

doi:10.1373/clinchem.2013.202531

Cited by 41 publications

(38 citation statements)

References 47 publications

(38 reference statements)

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“…However, so far, no explanation has been found for the observed higher cardiac troponin concentrations in men compared with women (26 ). These divergences have been related to intrinsic differences in the amount of cardiac troponins between the male and female myocardium, as well as to differences in the pathogenesis of coronary artery disease, with women presenting more often with endothelial dysfunction instead of the fixed coronary disease more often seen among men (27 ).…”

Section: Discussionmentioning

confidence: 97%

Sex-Specific Associations of Established and Emerging Cardiac Biomarkers with All-Cause Mortality in Older Adults: The ActiFE Study

et al. 2015

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Section: Discussionmentioning

confidence: 97%

Sex-Specific Associations of Established and Emerging Cardiac Biomarkers with All-Cause Mortality in Older Adults: The ActiFE Study

et al. 2015

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“…The distribution of BNP has been shown to be higher in women compared with men, in both healthy subjects as well as those with heart failure 27. Also, concentrations of galactin‐3 levels have been shown to be higher in women compared with men in population‐based studies, whereas soluble ST2 and growth differentiation factor‐15 have been shown to be lower in women compared with men 28. Although the exact role sex plays in cardiac diseases remains to be fully understood, what is known is that there are fundamental intrinsic sex differences in cardiac tissue 29.…”

Section: Discussionmentioning

confidence: 99%

Differentiating heart failure phenotypes using sex‐specific transcriptomic and proteomic biomarker panels

et al. 2017

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AimsHeart failure with preserved ejection fraction (HFpEF) accounts for 30–50% of patients with heart failure (HF). A major obstacle in HF management is the difficulty in differentiating between HFpEF and heart failure with reduced ejection fraction (HFrEF) using conventional clinical and laboratory investigations. The aim of this study is to develop robust transcriptomic and proteomic biomarker signatures that can differentiate HFpEF from HFrEF.Methods and resultsA total of 210 HF patients were recruited in participating institutions from the Alberta HEART study. An expert clinical adjudicating panel differentiated between patients with HFpEF and HFrEF. The discovery cohort consisted of 61 patients, and the replication cohort consisted of 70 patients. Transcriptomic and proteomic data were analysed to find panels of differentiating HFpEF from HFrEF. In the discovery cohort, a 22‐transcript panel was found to differentiate HFpEF from HFrEF in male patients with a cross‐validation AUC of 0.74, as compared with 0.70 for N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) in those same patients. An ensemble of the transcript panel and NT‐pro‐BNP yielded a cross‐validation AUC of 0.80. This performance improvement was also observed in the replication cohort. An ensemble of the transcriptomic panel with NT‐proBNP produced a replication AUC of 0.90, as compared with 0.74 for NT‐proBNP alone and 0.73 for the transcriptomic panel.ConclusionsWe have identified a male‐specific transcriptomic biomarker panel that can differentiate between HFpEF and HFrEF. These biosignatures could be further replicated on other patients and potentially be developed into a blood test for better management of HF patients.

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“…It has been repeatedly shown that men have higher cTn levels than women and that cTn levels increase with age [45,46]. Even though not all data suggest that the use of gender-specific cut-offs improves diagnostic performance of a cTn assay [47], establishing narrower reference ranges in more homogeneous control groups increases the diagnostic performance of any assay, cTn being no exception.…”

Section: What Is 99th Percentile Url and How Is It Established?mentioning

confidence: 99%

High sensitivity cardiac troponin assays in the clinical laboratories

Jarolím

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

117

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Abstract:Immunoassays measuring cardiac troponins I or T have become firmly established as critical tools for diagnosing acute myocardial infarction. While most contemporary assays provide adequate diagnostic performance, the increased sensitivity and precision of the new, high sensitivity assays that have already been introduced into clinical practice, provide the potential to further shorten intervals between blood draws or the time needed to detect the first significant troponin elevation. In addition to the relatively modest benefits at the diagnostic end, the high sensitivity assays and the investigational ultrasensitive cardiac troponin assays offer improvements for predicting major adverse cardiovascular events, development of heart failure or transition to end-stage kidney disease. These novel high sensitivity assays can measure troponin concentrations in 50%-100% of healthy individuals and therefore allow for the distribution of troponin values within a healthy cohort to be measured, patient's baseline troponin levels to be monitored, and clinicians to be alerted of deteriorating cardiorenal conditions. We envisage that the high sensitivity assays will become important tools for predicting each patient's risk of future adverse events and for guiding and monitoring corresponding adjustments of preventative therapeutic interventions.

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Biomarkers in ACS and Heart Failure: Should Men and Women Be Interpreted Differently?

Cited by 41 publications

References 47 publications

Sex-Specific Associations of Established and Emerging Cardiac Biomarkers with All-Cause Mortality in Older Adults: The ActiFE Study

Sex-Specific Associations of Established and Emerging Cardiac Biomarkers with All-Cause Mortality in Older Adults: The ActiFE Study

Differentiating heart failure phenotypes using sex‐specific transcriptomic and proteomic biomarker panels

High sensitivity cardiac troponin assays in the clinical laboratories

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