Increase in biomarkers and multimarker panel linked to increased risk for primary cardiorenal outcome
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Aug. 23, 2023 (HealthDay News) — For people with type 2 diabetes and albuminuria, canagliflozin reduces the longitudinal trajectory of increase in cardiorenal biomarkers, according to a study published online Aug. 22 in Circulation.
James L. Januzzi, M.D., from Massachusetts General Hospital in Boston, and colleagues measured concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T, growth differentiation factor-15, and insulin-like growth factor binding protein 7 (IGFBP7) in 2,627 participants in the Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation trial. The effect of canagliflozin was assessed on biomarker concentrations. The prognostic potential of each of the biomarkers was examined on the primary outcome (composite of end-stage renal disease, doubling of serum creatinine level, or renal death or cardiovascular death).
The researchers found that the biomarkers increased by 6 to 29 percent in the placebo arm and by 3 to 10 percent in the canagliflozin arm at one year. Cardiac and renal outcomes were strongly predicted by baseline concentrations of each biomarker. When the biomarkers were analyzed together in a multimarker panel, individuals with high- and moderate-risk scores had a higher risk for the primary outcome compared with those with low-risk scores (hazard ratios, 4.01 and 2.39, respectively). A 50 percent increase in NT-proBNP, high-sensitivity cardiac troponin T, growth differentiation factor-15, and IGFBP7 at one year were associated with risk for the primary outcome (hazard ratios, 1.11, 1.86, 1.45, and 3.76, respectively).
“It was reassuring to discover that canagliflozin helped reduce risks the most in people with the highest chances for complications,” Januzzi said in a statement.
Several authors disclosed ties to the pharmaceutical and medical device industries, including Janssen Research & Development, LLC, which funded the trial and analysis, and Roche Diagnostics, which provided reagents.
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