Abstract 11612: Serial Changes in Specific Biomarkers Reflect Cardiac Resynchronization Therapy Response: Results From the SMART-AV Trial
Background: Early identification of a favorable cardiac resynchronization therapy (CRT) response holds great clinical import. These studies often utilized a single biomarker or were performed at one point in time. The present study utilized an innovative approach whereby a panel of biomarkers were quantified in patients prior to CRT implant (Baseline) and then at 3 and 6 months post-CRT in a robust group of patients whereby CRT response had also been pre-specified.
Methods/Results: Plasma was collected from patients (SMART-AV trial), and a positive CRT response was pre-specified as a ≥15 mL reduction in LV end-systolic volume at 6 months post-CRT (Responders:n=390/Non-Responders:n=388). Through initial cohort testing and multivariate modeling, serial measures of a 12 biomarker cassette was selected using high sensitivity multiplex profiling, which consisted of C-reactive protein, soluble glycoprotein 130, soluble interleukin-2 receptor, soluble tumor necrosis factor receptor-II, interferon gamma, N-terminal brain natriuretic peptide (NT-proBNP), soluble suppressor of tumorgenicity-2 (sST-2), matrix metalloproteinases-2 and -9 (MMP-2, MMP-9), and tissue inhibitors of MMP (TIMP-1, -2, -4). Analysis of variance (ANOVA) for repeated measures identified that NT-proBNP, sST-2, and MMP-2 changed across time following CRT (by ANOVA, p<0.05 for all) and that these profiles changed with respect to CRT response (by ANOVA,p<0.05 for all). Moreover, differences in these biomarkers existed with respect to CRT response at specific time points (Table). Lower NT-proBNP and MMP-2 levels occurred in the CRT responder group at 3 and 6 months and lower sST-2 at 3 months.
Conclusion: The unique findings from this study identified that time dependent changes in a specific biomarker signature occur early in those patients likely to respond favorably to CRT, and as such, may be of potential utility for point of care testing and integration into the CRT evaluation algorithm.
Author Disclosures: S. Jacob: None. D.A. Morales: None. T.E. Meyer: Employment; Significant; Boston Scientific. C.M. Stolen: Employment; Significant; Boston Scientific. J.E. Van Eyk: None. M.R. Gold: None. S. Mittal: None. N. Wold: Employment; Significant; Boston Scientific. J.F. Beshai: None. K.M. Stein: Employment; Significant; Boston Scientific. K.A. Ellenbogen: None. F.G. Spinale: Research Grant; Modest; VA Merit. Research Grant; Significant; NIH. Consultant/Advisory Board; Significant; Boston Scientific.
- © 2014 by American Heart Association, Inc.