Abstract 2799: Procollagen Type III Amino-terminal and Carboxyl-terminal Telopeptide of Collagen type I but not Carboxyl-terminal Propeptide Type I are Associated with Heart Failure in the Elderly; The Cardiovascular Health Study
Background: The presence of excess myocardial matrix fibrosis (MF) contributes to alteration in the left ventricular (LV) diastolic and eventually, systolic performance. The increased collagen-derived serum peptides associated with collagen synthesis (procollagen type III aminoterminal peptide-PIIINP-, carboxyl-terminal propeptide type I -PIP-) and degradation (carboxyl-terminal telopeptide of collagen type I -CTIP-) have been shown in a number of small studies to correlate with histologic assessment of MF. While the prevalence of heart failure (HF), especially diastolic (D)HF increases with aging, no large studies evaluate the association of MF with DHF or systolic (S) HF in the elderly.
Aims: To determine the association between the 3 biomarkers of MF turnover
Methods: In 880 participants (ppt), mean age 77 ± 6 yrs, 52 % males, 79 % white, enrolled in the Cardiovascular Health Study, a prospective community based study of individuals > 65 yrs of age , serum levels of PIIINP, PIP and ICTP were measured by radioimmunoassay; 179 had HF with normal LVEF (DHF), 131 had HF with LVEF ± 55%, (SHF), 287 controls (no HF) and 283 healthy ppts.
Results: Logistic regression models using a progressive number of adjustment variables are illustrated in the table⇓. The ROC curves showed for CTIP the AUC =0.69; p<0.0001 and for PIIINP, AUC = 0.66, p<0.0001. The comparison of two ROC curves = NS. Model 1: unadjusted model Model 2: adjusted by age, gender and race Model 3: model 2+ adjustment for LVH, hypertension, diabetes, CHD, any ACE inhibitor, potassium-sparing agents alone, any diuretic, serum creatinine, cystatin C
Conclusions: 1. PIP was not associated with SHF or DHF. 2. Even when adjusted for multiple potential confounders, there is still a strong association between CTIP, PIIINP and DHF as well as SHF. 3. The lack of association between PIP and HF might be a characteristic of this age group where possible PIIINP, reflecting the poorly cross-linked collagen, predominates .