Abstract 12196: Combination of Pentosidine and Carboxy-Terminal Telopeptide of Type I Collagen Strongly Predicts Cardiac Events in Heart Failure Patients With Preserved Left Ventricular Ejection Fraction
Backgound: More than 40% of patients hospitalized with heart failure have preserved left ventricular ejection fraction (LVEF) and are at high risk for cardiac events. However, clinical markers to predict adverse outcome have not yet been established for patients with preserved LVEF. The aim of the present study was to elucidate whether a combination of markers (pentosidine, an advanced glycation end products (AGEs) which accumulates in extracellular matrix, especially in the collagen and carboxy-terminal telopeptide of type I collagen (I-CTP), which reflects collagen turnover) can reliably risk stratify patients with preserved LVEF.
Methods and Results: Serum levels of pentosidine and I-CTP were measured at admission in 150 consecutive patients hospitalized for chronic heart failure (CHF). Patients were divided into 2 groups based on the LVEF: reduced LVEF group (LVEF < 50 %, n = 67) and preserved LVEF group (LVEF ≥ 50 %, n = 83). Normal upper limits for pentosidine and I-CTP values were determined from the receiver operating characteristic curves (35 ng/ml for pentosidine and 5 pg/ml for I-CTP). In preserved LVEF group, a Cox regression hazard analysis demonstrated that pentosidine (hazard ratio 1.009, p < 0.01) and I-CTP (hazard ratio 1.174, p < 0.05) were independent predictors of cardiac events. High concentrations of both pentosidine and I-CTP at admission were associated with the highest incidence of cardiac events. Kaplan-Meier analysis also showed that the combination of pentosidine and I-CTP concentrations could reliably stratify patients for cardiac events.
Conclusions: Combined measurement of pentosidine and I-CTP concentrations at admission may be a strongly reliable evaluation for risk stratifying CHF patients with preserved LVEF. Our data indicate that not only collagen turnover but also accumulation of AGEs in extracellular matrix is associated with progressive heart failure with preserved LVEF.
- © 2010 by American Heart Association, Inc.