Evidence map›Paper›PMID 39663924›Full record

Trial reportEuropean journal of heart failure2025

End-organ protective effect of serelaxin in patients hospitalized for heart failure: Results of the biomarker substudy of Relaxin in Acute Heart Failure-2 (RELAX-AHF-2).

Adriaan A Voors, Marco Metra, Douwe Postmus, Barry H Greenberg, Gadi Cotter, Beth A Davison, Iris E Beldhuis, G Michael Felker, Gerasimos Filippatos, Peter S Pang and 3 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Adriaan A VoorsUniversity of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Marco MetraDepartment of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Douwe PostmusUniversity of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Barry H GreenbergDivision of Cardiology, University of California, San Francisco, San Diego, CA, USA.
Gadi CotterMomentum Research, Durham, NC, USA.
Beth A DavisonMomentum Research, Durham, NC, USA.
Iris E BeldhuisUniversity of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
G Michael FelkerDivision of Cardiology, Duke University School of Medicine, Durham, NC, USA.
Gerasimos FilippatosDepartment of Cardiology, Atttikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Peter S PangDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Piotr PonikowskiDepartment of Heart Diseases, Medical University, Military Hospital, Wrocław, Poland.
Claudio GimpelewiczNovartis Pharma, Basel, Switzerland.
John R TeerlinkSection of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California, San Francisco, San Francisco, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsSerelaxin is recombinant human relaxin-2, a hormone responsible for haemodynamic adaptations and organ protection in pregnancy. In the RELAX-AHF trial, serelaxin demonstrated reductions in cardiac, renal and hepatic damage. In RELAX-AHF-2, organ damage-related biomarkers were assessed in a biomarker substudy. METHODS AND

resultsPatients enrolled within 16 h of presentation for heart failure hospitalization were randomized to 48-h infusions of either serelaxin (30 μg/kg/day) or placebo, and plasma samples were obtained at baseline, 2, 5, and 14 days in patients participating in the biomarker substudy. Of the 6545 patients analysed in RELAX-AHF-2, 1020 (15.6%) patients (mean age 72 ± 12 years; 61% male) were enrolled in the biomarker substudy. Compared to placebo, serelaxin decreased percentage change from baseline in troponin T through day 14 (serelaxin +0.2% vs. placebo +40.3%; p = 0.042), as well as creatinine (-0.8% vs. +5.8%; p = 0.002), cystatin C (+3.8% vs. +8.3%; p = 0.016), and uric acid (+0.8% vs. +7.2%; p = 0.0014) at day 2. The decrease of N-terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline to day 2 was greater in serelaxin-treated patients (-39.8% vs. -27.6%; p = 0.002). Early changes in NT-proBNP and troponin, but not creatinine, cystatin C and uric acid, were associated with 180-day mortality. In this substudy population, serelaxin did not reduce 180-day cardiovascular death (hazard ratio [HR] 0.78; 95% confidence interval [CI] 0.49-1.25; p = 0.30), but significantly reduced worsening heart failure through day 5 (HR 0.55; 95% CI 0.33-0.93; p = 0.027).

conclusionIn this substudy, serelaxin decreased plasma concentrations of cardiac, renal and hepatic injury markers. Changes of most of these markers were associated with cardiovascular mortality. In this pre-specified biomarker subgroup, serelaxin did not reduce 180-day cardiovascular mortality but significantly reduced worsening heart failure through day 5.

Indexed as

Heart FailureRelaxinAgedAged, 80 and overBiomarkersCystatin CDouble-Blind MethodFemaleHospitalizationHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsRecombinant ProteinsTreatment OutcomeBiomarkersCystatin CNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Recombinant ProteinsRelaxinserelaxin protein, humanTroponin TAcute heart failureBiomarkersOrgan protectionPharmacotherapy

Identifiers

PMID39663924
PMCPMC12370583

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.