Abstract 13170: Prognostic Value of Plasma Aldosterone Levels on Long Term Cardiac Mortality in Japanese Patients with Myocardial Infarction
Background: It was reported higher aldosterone (ALD) levels were predictors of mortality risk in patients with heart failure or myocardial infarction (MI). The prognostic significance of ALD in the Japanese subjects with acute myocardial infarction remains unknown.
Methods: Baseline plasma ALD levels were quantified in a prospective cohort study of 175 consecutive Japanese patients with acute MI (141 men, 34 women, age 67.9±12.6) to determine if there was an association of ALD levels and long term cardiac events. The subjects were divided into two groups of elevated ALD group (group H) and non-elevated ALD group (group L) according to the median value of baseline plasma ALD for data analysis. The primary end point of the study was cardiac death. The secondary end point was left ventricular ejection fraction (LVEF) at 6-month follow-up, heart failure required hospitalization and all cause death.
Results: The median value of baseline ALD was 106.0 pg/ml in all patients. During a median follow-up of 994 days, cardiac death occurred in 13 patients (7.4%). Twenty patients (11.4%) experienced heart failure. All cause mortality was 10.3%. Patients of group H (N=90) with higher ALD had a significantly higher incidence of cardiac death, as compared to those of group L (N=85) with lower ALD (13.3% vs. 1.2%, P=0.0411). The LVEF at 6-month follow-up of group H was significantly lower than those of group L (54.3% vs. 63.7%, P<0.0001). The incidence of hospitalization due to heart failure tended to be higher in the group H than in the group L (17.8% vs. 4.7%, P=0.0846). Patients of group H were likely to die more frequently than patients of group L (15.6% vs. 4.7%, P=0.1311). Higher ALD were independent predictors of increased cardiac death in Cox regression analysis adjusted for age, sex, body mass index, LVEF, brain natriuretic peptide and medication at acute phase (adjusted hazard ratio=1.133[95%CI 1.077-1,193]; P<0.0001).
Conclusion: Among Japanese patients with MI, higher ALD were associated with long term left ventricular remodeling. Elevated ALD levels at acute phase were independent predictor of cardiac mortality.
- © 2011 by American Heart Association, Inc.