Variability of biomarkers in patients with chronic heart failure and healthy controls

Wouter C. Meijers, A. Rogier van der Velde, Anneke C. Muller Kobold, Janneke Dijck-Brouwer, Alan H. Wu, Allan S. Jaffe, Rudolf A. de Boer*

*Corresponding author for this work

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Abstract

Aims Biomarkers can be used for diagnosis, risk stratification, or management of patients with heart failure (HF). Knowledge about the biological variation is needed for proper interpretation of serial measurements. Therefore, we aimed to determine and compare the biological variation of a large panel of biomarkers in healthy subjects and in patients with chronic HF.

Methods and results The biological variability of established biomarkers [NT-proBNP and high-sensitivity troponin T (hsTnT)], novel biomarkers [galectin-3, suppression of tumorigenicity 2 (ST2), and growth differentiation factor 15 (GDF-15)], and renal/neurohormonal biomarkers (aldosterone, phosphate, parathyroid hormone, plasma renin concentration, and creatinine) was determined in 28 healthy subjects and 83 HF patients, over a period of 4 months and 6 weeks, respectively. The analytical (CVa), intraindividual (CVi), and interindividual (CVg) variations were calculated, as well as the reference change value (RCV), which reflects the percentage of change that may indicate a 'relevant' change. All crude biomarker levels were significantly increased or decreased in HF patients compared with controls (all P <0.01). Variation indices were comparable in healthy individuals and HF patients. CVi was not influenced by the individual levels of the biomarker itself. NT-proBNP and GDF-15 had relatively high CVi (21.8% and 16.6%) and RCV (61.7% and 64.3%), whereas ST2 (CVi, 15.0; RCV, 42.9%), hsTnT (CVi, 11.1; RCV, 31.4%), and galectin-3 (CVi, 8.1; RCV, 25.0%) had lower indices of variation.

Conclusion Biological variation indices are comparable between healthy subjects and HF patients for a broad spectrum of biomarkers. NT-proBNP and GDF-15 have substantial variation, with lower variation for ST2, hsTnT, and galectin-3. These data are instrumental in proper interpretation of biomarker levels in HF patients.

Original languageEnglish
Pages (from-to)357-365
Number of pages9
JournalEuropean Journal of Heart Failure
Volume19
Issue number3
DOIs
Publication statusPublished - Mar-2017

Keywords

  • Heart failure
  • Biomarkers
  • NT-proBNP
  • Biological variation
  • Management programme
  • GROWTH-DIFFERENTIATION FACTOR-15
  • BRAIN NATRIURETIC PEPTIDE
  • REFERENCE CHANGE VALUES
  • BIOLOGICAL VARIATION
  • SOLUBLE ST2
  • PROGNOSTIC VALUE
  • GALECTIN-3 LEVELS
  • TROPONIN-T
  • TRIAL
  • PLASMA

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