https://doi.org/10.1007/s00392-025-02625-4
1Universitätsklinikum Regensburg Klinik und Poliklinik für Innere Med. II, Kardiologie Regensburg, Deutschland; 2Universitätsklinikum Regensburg Institut für Klinische Chemie und Laboratoriumsmedizin Regensburg, Deutschland; 3Krankenhaus Barmherzige Brüder Regensburg Klinik für Kardiologie Regensburg, Deutschland
Aims:
Chronic heart failure represents a global health problem. NT-proBNP is known as gold standard biomarker for chronic heart failure. Previous studies suggest Secretoneurin as biomarker with prognostic impact in patients with cardiovascular diseases and heart failure. Recently, the prognostic value of Secretoneurin in a mixed cohort of patients with chronic heart failure and Implantable Cardioverter Defibrillator (ICD) was shown. Aim of this study was to assess a potential additive value of combined Secretoneurin and NT-proBNP.
Methods:
In the study 412 patients with an ICD were included. Blood samples of every patient were obtained to assess Secretoneurin and NT-proBNP. Follow-up was performed after 45 months. Data regarding all-cause mortality were obtained by death registries, attending physicians and telephone interviews. Combined Secretoneurin and NT-proBNP was formed by the product of both. Beside Secretoneurin and NT-proBNP, Diabetes, primary prevention ICD indication, coronary artery disease, eGFR, left ventricular ejection fraction and age were included in Cox regression analysis.
Results:
Secretoneurin was positively correlated with NT-proBNP (r = .52), age (r = .44) and serum creatinine (r = .65; each p < .001). Secretoneurin as well as NT-proBNP were significantly elevated in patients with left ventricular ejection fraction ≤ 40% compared to patients with left ventricular ejection fraction > 40% and significantly elevated in patients suffering from chronic kidney disease compared to patients without chronic kidney disease (each p < .001). Further, secretoneurin and NT-proBNP were significantly elevated in deceased patients (p < .001). In ROC analysis there was a significantly higher AUC of combined Secretoneurin and NT-proBNP (AUC: .78) compared to NT-proBNP (AUC: .76; p = .03) regarding all-cause mortality. In multivariate Cox regression analysis combined Secretoneurin and NT-proBNP, age and eGFR represented independent predictors regarding all-cause mortality (each p < .05), in opposite to NT-proBNP (p = n.s.).
Conclusions:
Combination of Secretoneurin and NT-proBNP shows additive prognostic capability regarding all-cause mortality. These findings underline the prognostic importance and potential benefit of Secretoneurin in patients with chronic heart failure and ICD.