Page 165 - Biomarkers for risk stratification and guidance in heart failure

Chapter 7
alter outcome, (ii) less side effects resulting in increased quality of life as needless therapy can be avoided, and (iii) a more cost effective treatment.
Using a broad panel of biomarkers, with different pathophysiologic backgrounds, might be helpful in identifying specific subgroups of HF patients, each with a different treatment approach. For example: elevated ST2 has been associated with increased effect of beta-blocker treatment99. Also, interaction seems to exist between the level of galectin-3 and the effects of statin therapy.100 However, although it has been suggested that patients with heart failure and raised levels of galectin-3 might benefit more from aldosterone antagonist therapy than patients with lower levels recent analysis failed to demonstrate such specific benefit.101,102
In order to assess a multi marker panel for individualized HF therapy, it is important first to evaluate possible interaction between different biomarkers and specific HF therapy in retrospective analyses. Thereafter prospective trials should be designed to validate the hypothesis gained from the retrospective trials.
164