Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure A Scientific Statement From the American Heart Association

Sheryl L. Chow, Alan S. Maisel, Inder Anand, Biykem Bozkurt, Rudolf A. de Boer, G. Michael Felker, Gregg C. Fonarow, Barry Greenberg, James L. Januzzi, Michael S. Kiernan, Peter P. Liu, Thomas J. Wang, Clyde W. Yancy, Michael R. Zile, Amer Heart Assoc Clinical Pharmac, Council Basic Cardiovascular Sci, Council Cardiovascular Dis Young, Council Cardiovascular & Stroke, Council Cardiopulmonary Critical, Council Epidemiology & PreventionCouncil Functional Genomics, Council Quality Care Out Comes Res

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Abstract

BACKGROUND AND PURPOSE: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers.

METHODS: The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through December 2016. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or contemporary clinical practice recommendations.

RESULTS: A number of biomarkers associated with HF are well recognized, and measuring their concentrations in circulation can be a convenient and noninvasive approach to provide important information about disease severity and helps in the detection, diagnosis, prognosis, and management of HF. These include natriuretic peptides, soluble suppressor of tumorgenicity 2, highly sensitive troponin, galectin-3, midregional proadrenomedullin, cystatin-C, interleukin-6, procalcitonin, and others. There is a need to further evaluate existing and novel markers for guiding therapy and to summarize their data in a standardized format to improve communication among researchers and practitioners.

CONCLUSIONS: HF is a complex syndrome involving diverse pathways and pathological processes that can manifest in circulation as biomarkers. A number of such biomarkers are now clinically available, and monitoring their concentrations in blood not only can provide the clinician information about the diagnosis and severity of HF but also can improve prognostication and treatment strategies.

Original languageEnglish
Pages (from-to)E1054-E1091
Number of pages38
JournalCirculation
Volume135
Issue number22
DOIs
Publication statusPublished - 30-May-2017

Keywords

  • AHA Scientific Statements
  • biomarkers
  • diagnosis
  • heart failure
  • patient care management
  • prognosis
  • therapeutics
  • BRAIN-NATRIURETIC PEPTIDE
  • PRESERVED EJECTION FRACTION
  • CARDIAC TROPONIN-T
  • FAMILY-MEMBER ST2
  • LEFT-VENTRICULAR DYSFUNCTION
  • HIGH-SENSITIVITY TROPONIN
  • WORSENING RENAL-FUNCTION
  • LONG-TERM MORTALITY
  • INCREASED SERUM CONCENTRATIONS
  • INITIATE LIFESAVING TREATMENT

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