Circulating biomarkers as predictors of cardiovascular clinical outcomes in full or partial remission patients with lymphoproliferative diseases
Biological Markers and Guided Therapy
The aim of the study was to identify optimal combination of circulating biomarkers for cardiovascular outcomes in full or partial remission patients with lymphoproliferative diseases. Method: One hundred eighty two out subjects with full or partial remission of limphoproliferative diseases (43 patients with multiple myeloma, 101 subjects with chronic lymphoid leukemia, and 10 patients with Hodgkin's and non-Hodgkin's lymphoma) who underwent cardiac computer tomography (CT) angiography and
... giography and documented coronary artery disease (CAD) were enrolled in the study. Healthy volunteers (n=52) matched age and sex were referred as control. All subjects gave their written informed consent to participation in the study. 86 Borys B. Samura Diagnosis and staging of limphoproliferative diseases were defined by current clinical practice guidelines. Results: The study population was followed-up for a mean of 36 months. One hundred ninety six cumulative clinical events occurred in 42 patients (23.1%) within the follow-up, with their distribution being as follows: 29 deaths, 65 cardiac arrhythmias, 17 cardiac ischemic events, 9 strokes (5 lacunar infarctions and 2 cardioembolic strokes), 37 CHF and 39 hospital admissions for cardiovascular reasons. No cardiovascular incidences were determined in control cohort patients. In the age-and sex-adjusted univariate analysis Gal-3 and NTpro-BNP had a strongest impact on cardiovascular incidences amongst comorbidities, hemodynamic, other biomarker variables. In multivariable analysis, Gal-3, NT-pro-BNP, and VE-catherin remained to be independent predictors for cardiovascular incidences. Using reclassification methods, however, it was found that the addition of NTpro-BNP to the ABC model (Gal-3) improved the relative IDI by 6.9% for cardiovascular incidences. Adding combination of two biomarkers (NT-pro-BNP + VE-catherin) to ABC model improved the relative IDI by 9.1% for cardiovascular incidences. For category-free NRI, 12% of events (p=0.001) and 20% of non-events (p=0.001) were correctly reclassified by the addition of NTpro-BNP + VE-catherin to the ABC model for cardiovascular incidences. In conclusion: Combination of Gal-3, NT-pro-BNP + VE-catherin remained statistically significant predictors for cardiovascular incidences within three-year observation.