Effect of serelaxin on cardiac, renal, and hepatic biomarkers in the Relaxin in Acute Heart Failure (RELAX-AHF) development program: correlation with outcomes
| Autor: | Marmor, Alon, Dorobantu, Maria, Schumacher, Christoph, Felker, G. Michael, Ponikowski, Piotr, Filippatos, Gerasimos, Bush, Christopher, Cotter, Gad, Trapani, Angelo, Edwards, Christopher, Prescott, Margaret, Werdan, Karl, Adams, Kirkwood, Severin, Thomas, Davison, Beth, Teerlink, John, Jondeau, Guillaume, Saini, Rajnish, Metra, Marco, Unemori, Elaine, Pang, Peter, Teichman, Sam, Voors, Adriaan, Greenberg, Barry, Masip, Josep, Grinfeld, Liliana |
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| Přispěvatelé: | Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC) |
| Rok vydání: | 2012 |
| Předmět: |
TROPONIN ELEVATION
Kidney Double-Blind Method Troponin T Heart failure serelaxin biomarkers Natriuretic Peptide Brain Humans Aspartate Aminotransferases Cystatin C Heart Failure congestion Relaxin Alanine Transaminase ASSOCIATION CARE EUROPEAN-SOCIETY Peptide Fragments Recombinant Proteins PREVALENCE Hospitalization Survival Rate Treatment Outcome MYOCARDIAL-INFARCTION Liver PROTECT Creatinine Acute Disease organ protection RELAX-AHF 3RD UNIVERSAL DEFINITION serelaxin Biomarkers TASK-FORCE |
| Zdroj: | Journal of the American College of Cardiology, 61(2), 196-206. ELSEVIER SCIENCE INC |
| ISSN: | 1558-3597 0735-1097 |
| Popis: | Objectives The aim of this study was to assess the effects of serelaxin on short-term changes in markers of organ damage and congestion and relate them to 180-day mortality in patients with acute heart failure. Background Hospitalization for acute heart failure is associated with high post-discharge mortality, and this may be related to organ damage. Methods The Pre-RELAX-AHF (Relaxin in Acute Heart Failure) phase II study and RELAX-AHF phase III study were international, multicenter, double-blind, placebo-controlled trials in which patients hospitalized for acute heart failure were randomized within 16 h to intravenous placebo or serelaxin. Each patient was followed daily to day 5 or discharge and at days 5, 14, and 60 after enrollment. Vital status was assessed through 180 days. In RELAX-AHF, laboratory evaluations were performed daily to day 5 and at day 14. Plasma levels of biomarkers were measured at baseline and days 2, 5, and 14. All-cause mortality was assessed as a safety endpoint in both studies. Results Serelaxin reduced 180-day mortality, with similar effects in the phase II and phase III studies (combined studies: N = 1,395; hazard ratio: 0.62; 95% confidence interval: 0.43 to 0.88; p = 0.0076). In RELAX-AHF, changes in markers of cardiac (high-sensitivity cardiac troponin T), renal (creatinine and cystatin-C), and hepatic (aspartate transaminase and alanine transaminase) damage and of decongestion (N-terminal pro-brain natriuretic peptide) at day 2 and worsening heart failure during admission were associated with 180-day mortality. Serelaxin administration improved these markers, consistent with the prevention of organ damage and faster decongestion. Conclusions Early administration of serelaxin was associated with a reduction of 180-day mortality, and this occurred with fewer signs of organ damage and more rapid relief of congestion during the first days after admission. (J Am Coll Cardiol 2013; 61: 196-206) (C) 2013 by the American College of Cardiology Foundation |
| Databáze: | OpenAIRE |
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