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Pro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF study.
- Source :
-
ESC heart failure [ESC Heart Fail] 2018 Dec; Vol. 5 (6), pp. 1052-1059. Date of Electronic Publication: 2018 Aug 25. - Publication Year :
- 2018
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Abstract
- Aims: Neuroendocrine activation is associated with poor outcome in heart failure (HF). The neuropeptide gastrin-releasing peptide (GRP), derived from the precursor proGRP1-125 (proGRP), has recently been implicated in inflammation and wound repair. We investigated the predictive value of proGRP on clinical outcomes in HF patients with reduced ejection fraction.<br />Methods and Results: The association between plasma proGRP (time-resolved immunofluorometric assay) and the primary endpoint of death from any cause or first hospitalization for worsening of HF was evaluated using multivariable Cox proportional hazard models in 1541 patients with systolic HF and mild to moderate anaemia, enrolled in the Reduction of Events by Darbepoetin alfa in Heart Failure (RED-HF) trial. Median proGRP levels in the RED-HF cohort were markedly increased [95 ng/L (25th, 75th percentile, 69-129 ng/L)] with 64% patients above the 80 ng/L reference limit. Baseline proGRP correlated with estimated glomerular filtration rate (r = 0.52), N terminal pro brain natriuretic peptide (r = 0.33), troponin T (r = 0.34), and haemoglobin (r = 0.16) (all P < 0.001). The incidence outcome increased with increasing tertiles of baseline proGRP (primary endpoint third tertile vs. the lowest tertile; hazard ratio 1.91; 95% confidence interval 1.60-2.28, P < 0.001). However, these associations were markedly attenuated and non-significant in adjusted models. No interaction between baseline proGRP and the effect of darbepoetin alfa treatment was detected. Moreover, no significant association between changes in proGRP during 6 month follow-up and outcome was observed.<br />Conclusions: Pro-gastrin-releasing peptide is increased in patients with HF with reduced ejection fraction and anaemia, in particular in patients with poor renal function. However, proGRP adds little as a prognostic marker on top of conventional HF risk factors.<br /> (© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)
- Subjects :
- Aged
Anemia blood
Anemia drug therapy
Biomarkers blood
Dose-Response Relationship, Drug
Female
Heart Failure drug therapy
Heart Failure physiopathology
Hematinics administration & dosage
Humans
Injections, Subcutaneous
Male
Middle Aged
Prognosis
Stroke Volume physiology
Anemia complications
Darbepoetin alfa administration & dosage
Gastrin-Releasing Peptide blood
Heart Failure complications
Subjects
Details
- Language :
- English
- ISSN :
- 2055-5822
- Volume :
- 5
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- ESC heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 30145817
- Full Text :
- https://doi.org/10.1002/ehf2.12312