Abstract 828: Serum Midkine Predicts Cardiac Events in Chronic Heart Failure Patients
Midkine (MK), a heparin-binding growth factor, has various functions such as migration of inflammatory cell and anti-apoptotic effect. Invasion of inflammatory cells and cardiomyocyte apoptosis are involved in development and progression of heart failure (HF). However, relationship between MK and HF has not been previously examined. Therefore, we examined clinical significance of serum MK levels to determine the prognosis of HF patients. Serum levels of MK were measured at admission in 216 consecutive patients hospitalized for chronic HF and 60 control subjects. Patients were prospectively followed during a median follow-up period of 658 days with the end points of cardiac death and progressive HF requiring re-hospitalization. Serum concentrations of MK were significantly higher in patients with HF than in controls and increased as NYHA functional class rose (fig 1⇓). There were 74 cardiac events, including 30 cardiac deaths and 44 re-hospitalization for HF during follow-up period. Patients with cardiac events had significantly higher concentrations of MK than those without cardiac events (539 ± 57 pg/ml vs. 331 ± 17 pg/ml, P < 0.01). Patients were divided into 4 groups based on midkine levels. Risk of cardiac events increased as MK levels rose (fig 2⇓). In addition, the Cox multivariate hazard analysis showed that MK was an independent predictor of cardiac events (hazard ratio 1.280, 95% CI 1.027–1.578, P<0.05). Serum MK level is increased in HF patients, and MK is a novel marker for risk stratifying chronic HF patients.