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Licensed Unlicensed Requires Authentication Published by De Gruyter July 30, 2015

The role of timely measurement of galectin-3, NT-proBNP, cystatin C and hsTnT in predicting prognosis and heart function after heart transplantation

  • Janka Franeková , Lenka Hošková , Peter Sečník , Michal Pazderník , Markéta Kotrbatá , Zdeněk Kubíček and Antonín Jabor EMAIL logo

Abstract

Background: Changes of biomarkers measured soon after heart transplantation (HTx) can reflect different processes: cardiomyocyte necrosis (troponins, high-sensitivity cardiac TnT and TnI), heart function (natriuretic peptides, BNP and NT-proBNP), fibrosis (galectin-3 and ST2), and global cardiorenal risk (cystatin C). We assessed the prognostic role of hsTnT, NT-proBNP, galectin-3 and cystatin C during the early post-transplant period.

Methods: A total of 121 consecutive post-HTx patients were assessed. The main outcomes were survival, left ventricular ejection fraction (LVEF) and rejection periods. Survival was assessed after intermediate (12 months) and long periods (total follow-up during study, median of survival 763 days, IR 527–1038 days). LVEF was assessed 12 months after HTx. Rejection was evaluated during follow-up. We report biomarker concentrations measured 10 days and 12 months after HTx.

Results: Ten days after HTx, cystatin C and hsTnT predicted death both under univariable and multivariable analysis. These two biomarkers along with galectin-3 were increased in patients with decreased LVEF measured 1 year after HTx. NT-proBNP did not show early prognostic power. None of the measured biomarkers predicted rejection, but hsTnT and NT-proBNP were increased significantly 12 months after HTx in patients with at least one rejection.

Conclusions: Cystatin C and hsTnT measured 10 days after HTx can provide prognostic information on survival and galectin-3 measured at the same time may display a relationship to heart function assessed 1 year after HTx. Further study should be carried out in a large cohort of patients.


Corresponding author: Antonín Jabor, Institute for Clinical and Experimental Medicine, Department of Laboratory Methods, Vídeňská 1958/9, 140 21 Prague, Czech Republic, Phone: +420 236 055236, Fax: +420 261 363023, E-mail: ; and Charles University, 3rd Medical Faculty, Prague, Czech Republic

Acknowledgments

We express our thanks to Dr. V. Lánská for valuable comments on the statistical evaluation of results.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: Antonín Jabor received lecturer’s honoraria Abbott Laboratories Ltd., Czech Republic and Roche Ltd., Czech Republic. None of the other authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose. The study was partially supported by the project for conceptual development of research organizations 00023001 (Ministry of Health, Czech Republic) and the International Grant Agency of the Ministry of Health of the Czech Republic No NT/11269-5.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2014-12-8
Accepted: 2015-6-18
Published Online: 2015-7-30
Published in Print: 2016-2-1

©2016 by De Gruyter

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