Abstract 2565: High Serum Level of Pentosidine, an Advanced Glycation End Product (AGE), is a Risk Factor of Patients with Heart Failure
Background: Pentosidine, one of the advanced glycation end products (AGE), is generated by nonenzymatic glycation and oxidation of proteins. The receptor for AGE (RAGE) is expressed in a variety of tissues, and interaction of AGE with RAGE induces oxidative stress and activation of intracellular signaling causing production of cytokines and mediators of inflammation. We investigated whether serum pentosidine is a risk factor for heart failure.
Methods: Serum pentosidine was measured in 141 patients with heart failure. Patients were prospectively followed during a median follow-up period of 479 days.
Results: Serum pentosidine was significantly higher in NYHA class III/IV patients than in NYHA class I/II patients (P < 0.0001). Serum pentosidine was also higher in patients with cardiac events than in event free patients (P < 0.0001). In the univariate Cox proportional hazard analysis, age, NYHA class, pentosidine, creatinine, uric acid and B-type natriutic peptide were significant risk factors to predict cardiac events. In the multivariate Cox analysis, serum pentosidine was an independent risk factor for cardiac events (hazard ratio 1.60, 95% confidence interval 1.17 – 2.19, P = 0.005). Patients were divided into 4 groups based on the pentosidine levels (1st ≤ 22.9, 2nd 23.0 –31.9, 3rd 32.0 – 46.5 and 4th ≥ 46.6 ng/ml). The highest 4th quartile of pentosidine was associated with the highest risk of cardiac events (4.52-fold, figure 1⇓). Kaplan-Meier analysis demonstrated that patients in the 4th quartile had a significantly lower cardiac event-free rate than other tree quartiles (figure 2⇓).
Conclusions: Serum pentosidine is a novel independent prognostic factor for heart failure.