Article

Novel uses of clinically established cardiac biomarkers

Announcing new solutions in our cardiac biomarker portfolio, including novel uses of clinically established cardiac biomarkers.

N-terminal pro-brain natriuretic peptide test (NT-proBNP), the gold standard biomarker1 in heart failure, can now be used to assess the risk of heart failure in patients with Type 2 Diabetes2 and to help in stroke prevention in elderly individuals at risk for Atrial Fibrillation.3

 

Following both cardiac and non-cardiac procedures, recent data confirmed the value of high sensitivity cardiac troponin(hs-cTnT), where in perioperative use it can be used to predict major adverse cardiac events (MACE).4-6

 

Both Elecsys® NT-proBNP and Elecsys® cTnT-hs can be run on all cobas e analysers. They are among the first products certified under the new European In Vitro Diagnostics Regulation (IVDR) and available as of today in countries accepting CE mark. Availability in other countries is subject to local registration processes and timelines.

Heart illustration

NT-proBNP in heart failure risk assessment in patients with Type 2 Diabetes
 

Heart Failure is one of the earliest and second most common cardiovascular complications in Type 2 diabetes mellitus (T2DM), affecting approximately 30% of T2DM patients.7


Compared to non-diabetic patients, heart failure significantly impacts patients’ clinical course by frequent hospitalizations and longer length of hospital stays (LOS).7


The new intended use of Elecsys® NT-proBNP provides healthcare professionals with a precise biomarker that supports them to identify patients with high cardiovascular risk. This means that effective drug treatment can be started early so that cardioprotective treatment can be optimized. In PONTIAC-I it was shown that 65% of hospitalisations or death could be prevented.8

Perioperative use of (hs-cTnT) in non-cardiac surgery



Perioperative MACE, defined as death or myocardial infarction (MI), following both cardiac and non-cardiac procedures are a common cause of perioperative death and major morbidity.5,9



Over 200 million adults globally undergo major non-cardiac surgery every year. Of these, over 10 million suffer from major adverse cardiac events (MACE) in the first 30 days after non-cardiac surgery and more than 80% of those are clinically asymptomatic.9 The new intended use for Elecsys® cTnT-hs provides healthcare professionals with a biomarker that helps to predict the perioperative risk of a heart attack and to a perioperative heart attack in non-cardiac surgeries to allow clinicians to tailor surgery and post-operative care accordingly.4-6

Heart illustration

Identification of elderly individuals at high risk for Atrial Fibrillation



One-third of individuals with Atrial fibrillation (AFib) might be asymptomatic or have symptoms that are not specific to Afib. These individuals are less likely to seek healthcare or may not receive appropriate treatment which puts them at a higher risk of an ischemic stroke.10



One of the key elements in reducing stroke is early detection of people at risk of Atrial Fibrillation by better identification methods.11 Our second launched intended use for Elecsys® NT-proBNP provides healthcare professionals with a biomarker based solution that identifies people at risk and, in combination with a single lead (or higher) ECG, can aid successful diagnosis so therapy can be started. 3

ABC bleeding and stroke risk scores


Balancing AFib patient's risks of stroke and bleeding is necessary for optimal use of oral anticoagulants (OACs) in clinical practice.11-12


The European Society of Cardiology (ESC), American Heart Association (AHA), American College of Cardiology (ACC), Heart Rhythm Society (HRS) guideline, and Asia Pacific Heart Rhythm Society (APHRS) consensus recommend balancing both stroke and bleeding risk in AF patients who are being considered for OAC therapy.13-15


ABC-stroke risk and -bleeding risk scores can help identify the most appropriate OAC therapy option for the patient, improving their stroke and bleeding outcomes while managing their overall cardiovascular health.15-18

References

  1. McKie, PM., et al. (2016). J Am Coll Cardiol 68(22), 2437-2439
  2. Huelsmann M. et al. JACC. 2013, 62:1365-72
  3. Gudmundsdottir, K. et al. (2020). Eurospace 22, 24-32
  4. Devereaux PJ, Biccard BM, Sigamani A, et al. (2017). Association of Postoperative High-Sensitivity Troponin Levels With Myocardial Injury and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery. Jama 317, 1642-1651
  5. Puelacher C, Lurati Buse G, Seeberger D, et al. (2018). Perioperative Myocardial Injury After Noncardiac Surgery: Incidence, Mortality, and Characterization. Circulation 137 1221-1232
  6. Gillmann HJ, Meinders A, Grohennig A, et al. (2014). Perioperative levels and changes of high-sensitivity troponin T are associated with cardiovascular events in vascular surgery patients. Crit Care Med 42, 1498-1506
  7. Olchanski, N. et al., Cardiovasc. Endocrinol. Metab., 2020; Vol. 9, pp. 17-23
  8. Huelsmann, M. et al., J Am Coll Cardiol., 2013; Vol. 62, pp. 1365-1372
  9. Devereaux PJ, Sessler DI. (2015). Cardiac complications in patients undergoing major noncardiac surgery. N Engl J Med 373, 2258-2269
  10. Aronsson M. Eurospace (2015) 17, 1023–1029
  11. January, C. T. Circulation (2014); 130(23): e199-267
  12. Chiang, C.E. J Arrhythm (2017); 33(4): 345-367; 33
  13. Hindricks, G. Eur Heart J (2020) Aug 29; ehaa612
  14. January, et al. Circulation 2019; 140:e125–51
  15. Hijazi Z, et al. Lancet 2016; 387, 2302–2311
  16. Hijazi et al. (2016). Eur Heart J 37, 1582–90
  17. Oldgren et al. (2016). Circulation 134, 1697–707
  18. Berg et al. (2019). Circulation 139, 760–71