A cardiac biomarker is a molecule of varying nature (proteins, metabolites, microRNAs ...) that is released into the blood when heart damage occurs. Reference patterns as biomarkers in heart failure are the type B natriuretic peptide and the aminoterminal fraction of the type B natriuretic propeptide, which play an important role in the diagnosis, prognosis and treatment of decompensated acute cardiac insufficiency. However, more and more biomarkers are discovered and associated with other processes of myocardial injury, neurohormonal activation and remodeling of the ventricular heart.
Fig. Bayés-Genís A, et al. European Heart Journal, 2017 (adapted from Braunwald, et al.)
Heart failure is a very heterogeneous disease without an individualized therapeutic approach. Currently, in other types of diseases such as cancer, more personalized treatments are being sought depending on the individualized characteristics of each patient. In this same way, we think that a more personalized approach is needed for the management of heart failure. As a result of this situation, the Pure Heart Precision Medicine Platform is born within the ICREC group, for optimizing the value of certain biomarkers that improve the diagnosis, prognosis and the management of the patients with heart failure.
In this regard, we have recently published several papers that demonstrate the association of certain biomarkers with the ability to predict the evolution of the patient's disease and stratification risk. For example, in patients with severe asymptomatic aortic stenosis, a concentration of high sensitivity troponin T greater than 10ng/L is associated with a high risk of events within 12 months and the inclusion of this biomarker in the management of This pathology makes it possible to significantly improve risk prediction metrics. We have also seen that in patients with myocardial infarction with elevation of the ST segment, the assessment of the circulating levels of GDF-15 in the first 24 hours is very valuable to predict especially short-term results. We have recently developed an ST2-R2 score that allows the clinical practice to predict the reverse remodeling of the left ventricle in patients with systolic heart failure. In turn, we have patented neprilisin as a prognostic biomarker of heart failure.
We are currently deepening in the study of known biomarkers and discovering new biomarkers that help us improving the management of cardiac pathology. For this, we have extensive collections of plasma and serum samples of treated patients in the Cardiology Service and we collaborate with other hospitals, both national and international.
- Bayes-Genis A, Voors AA, Zannad F, Januzzi JL, Mark Richards A, Díez J. Transitioning from usual care to biomarker-based personalized and precision medicine in heart failure: call for action. Eur Heart J. 2018 Aug 7;39(30):2793-2799
- Bayes-Genis A, Núñez J, Zannad F, Ferreira JP, Anker SD, Cleland JG, Dickstein K, Filippatos G, Lang CC, Ng LL, Ponikowski P, Samani NJ, van Veldhuisen DJ, Zwinderman AH, Metra M, Lupón J, Voors AA. The PCSK9-LDL Receptor Axis and Outcomes in Heart Failure: BIOSTAT-CHF Subanalysis. J Am Coll Cardiol. 2017;70:2128-2136
- Bayés-Genís A, Barallat J, Galán A, de Antonio M, Domingo M, Zamora E, Urrutia A, Lupón J. Soluble neprilysin is predictive of cardiovascular death and heart failure hospitalization in heart failure patients. J Am Coll Cardiol. 2015; 65:657-65
- Bayes-Genis A, Barallat J, Galán A, de Antonio M, Domingo M, Zamora E, Gastelurrutia P, Vila J, Peñafiel J, Gálvez-Montón C, Lupón J. Multimarker Strategy for Heart Failure Prognostication. Value of Neurohormonal Biomarkers: Neprilysin vs NT-proBNP. Rev Esp Cardiol. 2015 Dec,68(12):1075-84
- Ferrer-Sistach E, Lupón J, Cediel G, Teis A, Gual F, Serrano S, Vallejo N, Juncà G, López-Ayerbe J, Bayés-Genís A. High-sensitivity troponin T in asymptomatic severe aortic stenosis. Biomarkers. 2019 Jan 11:1-7
- Lupón J, Simpson J, McMurray JJV, de Antonio M, Vila J, Subirana I, Barallat J, Moliner P, Domingo M, Zamora E, Bayes-Genis A. Barcelona Bio-HF Calculator Version 2.0: incorporation of angiotensin II receptor blocker neprilysin inhibitor (ARNI) and risk for heart failure hospitalization. Eur J heart Fail. 2018 May,20(5):938-940
- Lupón J, Bayes-Genis A. Neprilysin Plasma Concentrations: A new prognostic marker in Heart Failure. Rev Esp Cardiol. 2016 May, 69(5):535-6
- Lupon, J., et al., Biomarker-assist score for reverse remodeling prediction in heart failure: The ST2-R2 score. Int J Cardiol. 2015. 184: p. 337-43
- Rueda F, Lupón J, García-García C, Cediel G, Aranda Nevado MC, Serra Gregori J, Labata C, Oliveras T, Ferrer M, de Diego O, Serra J, Revuelta López E, Bayés-Genís A. Acute-phase dynamics and prognostic value of growth differentation factor-15 in ST-elevation myocardial infarction. Clin Chem Lab Med. 2019 Feb 1