Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.jacc.2018.11.060
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dc.titleCombining Circulating MicroRNA and NT-proBNP to Detect and Categorize Heart Failure Subtypes
dc.contributor.authorWong, Lee Lee
dc.contributor.authorZou, Ruiyang
dc.contributor.authorZhou, Lihan
dc.contributor.authorLim, Jia Yuen
dc.contributor.authorPhua, Dominic CY
dc.contributor.authorLiu, Chengcheng
dc.contributor.authorChong, Jenny PC
dc.contributor.authorNg, Jessica YX
dc.contributor.authorLiew, Oi Wah
dc.contributor.authorChan, Siew Pang
dc.contributor.authorChen, Yei-Tsung
dc.contributor.authorChan, Michelle MY
dc.contributor.authorYeo, Poh Shuan D
dc.contributor.authorNg, Tze Pin
dc.contributor.authorLing, Lieng H
dc.contributor.authorSim, David
dc.contributor.authorLeong, Kui Toh G
dc.contributor.authorOng, Hean Y
dc.contributor.authorJaufeerally, Fazlur
dc.contributor.authorWong, Raymond
dc.contributor.authorChai, Ping
dc.contributor.authorLow, Adrian F
dc.contributor.authorLund, Mayanna
dc.contributor.authorDevlin, Gerry
dc.contributor.authorTroughton, Richard
dc.contributor.authorCameron, Vicky A
dc.contributor.authorDoughty, Robert N
dc.contributor.authorLam, Carolyn SP
dc.contributor.authorToo, Heng Phon
dc.contributor.authorRichards, Arthur Mark
dc.date.accessioned2022-11-15T06:45:04Z
dc.date.available2022-11-15T06:45:04Z
dc.date.issued2019-03-26
dc.identifier.citationWong, Lee Lee, Zou, Ruiyang, Zhou, Lihan, Lim, Jia Yuen, Phua, Dominic CY, Liu, Chengcheng, Chong, Jenny PC, Ng, Jessica YX, Liew, Oi Wah, Chan, Siew Pang, Chen, Yei-Tsung, Chan, Michelle MY, Yeo, Poh Shuan D, Ng, Tze Pin, Ling, Lieng H, Sim, David, Leong, Kui Toh G, Ong, Hean Y, Jaufeerally, Fazlur, Wong, Raymond, Chai, Ping, Low, Adrian F, Lund, Mayanna, Devlin, Gerry, Troughton, Richard, Cameron, Vicky A, Doughty, Robert N, Lam, Carolyn SP, Too, Heng Phon, Richards, Arthur Mark (2019-03-26). Combining Circulating MicroRNA and NT-proBNP to Detect and Categorize Heart Failure Subtypes. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 73 (11) : 1300-1313. ScholarBank@NUS Repository. https://doi.org/10.1016/j.jacc.2018.11.060
dc.identifier.issn0735-1097
dc.identifier.issn1558-3597
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/234578
dc.description.abstractBackground: Clinicians need improved tools to better identify nonacute heart failure with preserved ejection fraction (HFpEF). Objectives: The purpose of this study was to derive and validate circulating microRNA signatures for nonacute heart failure (HF). Methods: Discovery and validation cohorts (N = 1,710), comprised 903 HF and 807 non-HF patients from Singapore and New Zealand (NZ). MicroRNA biomarker panel discovery in a Singapore cohort (n = 546) was independently validated in a second Singapore cohort (Validation 1; n = 448) and a NZ cohort (Validation 2; n = 716). Results: In discovery, an 8-microRNA panel identified HF with an area under the curve (AUC) 0.96, specificity 0.88, and accuracy 0.89. Corresponding metrics were 0.88, 0.66, and 0.77 in Validation 1, and 0.87, 0.58, and 0.74 in Validation 2. Combining microRNA panels with N-terminal pro–B-type natriuretic peptide (NT-proBNP) clearly improved specificity and accuracy from AUC 0.96, specificity 0.91, and accuracy 0.90 for NT-proBNP alone to corresponding metrics of 0.99, 0.99, and 0.93 in the discovery and 0.97, 0.96, and 0.93 in Validation 1. The 8-microRNA discovery panel distinguished HFpEF from HF with reduced ejection fraction with AUC 0.81, specificity 0.66, and accuracy 0.72. Corresponding metrics were 0.65, 0.41, and 0.56 in Validation 1 and 0.65, 0.41, and 0.62 in Validation 2. For phenotype categorization, combined markers achieved AUC 0.87, specificity 0.75, and accuracy 0.77 in the discovery with corresponding metrics of 0.74, 0.59, and 0.67 in Validation 1 and 0.72, 0.52, and 0.68 in Validation 2, as compared with NT-proBNP alone of AUC 0.71, specificity 0.46, and accuracy 0.62 in the discovery; with corresponding metrics of 0.72, 0.44, and 0.57 in Validation 1 and 0.69, 0.48, and 0.66 in Validation 2. Accordingly, false negative (FN) (81% Singapore and all NZ FN cases were HFpEF) as classified by a guideline-endorsed NT-proBNP ruleout threshold, were correctly reclassified by the 8-microRNA panel in the majority (72% and 88% of FN in Singapore and NZ, respectively) of cases. Conclusions: Multi-microRNA panels in combination with NT-proBNP are highly discriminatory and improved specificity and accuracy in identifying nonacute HF. These findings suggest potential utility in the identification of nonacute HF, where clinical assessment, imaging, and NT-proBNP may not be definitive, especially in HFpEF.
dc.language.isoen
dc.publisherELSEVIER SCIENCE INC
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectCardiac & Cardiovascular Systems
dc.subjectCardiovascular System & Cardiology
dc.subjectbiomarker
dc.subjectdiagnosis
dc.subjectheart failure
dc.subjectmicroRNA
dc.subjectBRAIN NATRIURETIC PEPTIDE
dc.subjectREDUCED EJECTION FRACTION
dc.subjectDIAGNOSIS
dc.subjectASSOCIATION
dc.subjectPREVALENCE
dc.subjectEXPRESSION
dc.subjectBIOMARKER
dc.subjectACCURACY
dc.subjectMARKERS
dc.subjectTRENDS
dc.typeArticle
dc.date.updated2022-11-14T07:03:18Z
dc.contributor.departmentDEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
dc.contributor.departmentDEPT OF BIOCHEMISTRY
dc.contributor.departmentDEPT OF MEDICINE
dc.contributor.departmentDEPT OF PSYCHOLOGICAL MEDICINE
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.contributor.departmentSINGAPORE-MIT ALLIANCE
dc.description.doi10.1016/j.jacc.2018.11.060
dc.description.sourcetitleJOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
dc.description.volume73
dc.description.issue11
dc.description.page1300-1313
dc.published.statePublished
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