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Relationship between osteoprotegerin and mortality in decompensated heart failure with preserved ejection fraction.
- Source :
-
Journal of cardiovascular medicine (Hagerstown, Md.) [J Cardiovasc Med (Hagerstown)] 2015 Jun; Vol. 16 (6), pp. 438-43. - Publication Year :
- 2015
-
Abstract
- Aim: The aim of this study was to evaluate whether osteoprotegerin - an emerging inflammatory biomarker in cardiovascular diseases - predicts outcomes in patients with acute heart failure and preserved ejection fraction.<br />Methods: We measured urea, creatinine, hemoglobin, high-sensitivity C-reactive protein, N-terminal pro-B-type natriuretic peptide and osteoprotegerin on admission in 177 patients admitted with decompensated heart failure and left ventricular ejection fraction at least 45%. The population was divided according to the median values of osteoprotegerin (158.6 ng/l). Primary and secondary endpoints were all-cause mortality and death/readmission at 1-year follow-up, respectively. Multivariable Cox models were generated for osteoprotegerin and common risk factors. We also evaluated the reclassification of patients into risk categories after adding this biomarker to the model.<br />Results: A total of 43 patients died during the follow-up and 84 had a combined event. Kaplan-Meier curves showed significantly increased primary and secondary endpoints according to the median of osteoprotegerin (log-rank, P < 0.0001 and 0.001, respectively). After adjustment for age, estimated glomerular filtration rate, hemoglobin, N-terminal pro-B-type natriuretic peptide, BMI and New York Heart Association III-IV, osteoprotegerin was a significant predictor of primary endpoint evaluated as continuous and categorized variable (relative risk 2.49, 95% confidence interval 1.18-5.24, P = 0.016 and relative risk 2.35, 95% confidence interval 1.11-4.96, P = 0.025, respectively). The clinical prediction model with osteoprotegerin evaluated with Net Reclassification Index was not significant.<br />Conclusion: Osteoprotegerin is independently associated with all-cause mortality in patients hospitalized for heart failure with preserved ejection fraction. However, adding this biomarker into a risk model does not improve its prediction value.
- Subjects :
- Acute Disease
Aged
Aged, 80 and over
Biomarkers blood
Female
Follow-Up Studies
Heart Failure blood
Heart Failure physiopathology
Hospitalization
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Prognosis
Prospective Studies
Risk Assessment methods
Stroke Volume physiology
Heart Failure diagnosis
RANK Ligand blood
Subjects
Details
- Language :
- English
- ISSN :
- 1558-2035
- Volume :
- 16
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular medicine (Hagerstown, Md.)
- Publication Type :
- Academic Journal
- Accession number :
- 25469731
- Full Text :
- https://doi.org/10.2459/JCM.0000000000000229