Abstract 16040: Diagnostic and Prognostic Value of Osteopontin in Acute Congestive Heart Failure
PURPOSE: Congestive heart failure is characterized by an adverse structural remodeling of the myocardium. Osteopontin (OPN) is a glycoprotein being expressed in cardiomyocytes and fibroblasts. OPN is involved in extracellular matrix formation and acts as a mediator of myocardial remodeling and fibrosis. This study evaluates serum levels of ostepontin in patients suffering from acute congestive heart failure (aCHF). PATIENTS AN.
METHODS: 401 patients presenting with symptoms of acute dyspnea and/or peripheral edema in the emergency department were evaluated. Patients suffering from severe renal disease (defined as serum creatinine level greater than 2.8 mg/dl) or anemia (hemoglobin concentrations below 8.0 g/dl) were excluded. Patients were followed up to five years after initial presentation in the emergency department. Blood samples for measurement of OPN (Quantikine®, R&D Systems, Inc) were collected immediately after the initial clinical presentation.
RESULTS: Median OPN levels were significantly higher in patients with aCHF (106.3 ng/ml, n=122) as compared to patients without aCHF (82.6 ng/ml, n=279) (P=0.0001). Median OPN levels were significantly higher in NYHA class III/IV patients (107.3 ng/ml, n=128) compared to NYHA class I/II pts (86.2 pg/ml, n=70) (P=0.01). Accordingly, median OPN levels were significantly higher in ACC/AHA class C/D patients (96.9 ng/ml, n=215) compared to class A/B pts (76.32 ng/ml, n=132) (P=0.0001). Patients with left ventricular dysfunction had significantly higher median levels of OPN (99.5 ng/ml, n=91) compared to pts without LV dysfunction (81.6 ng/ml, n= 135) (P=0.0009). Mortality rates were 14% (57/401) at 1 year and 32% (129/401) at 5 years. Median OPN levels were significantly higher in patients who died during follow-up (1 year: 134.4 ng/ml vs. 84.7 ng/ml, P=0.0001; 5 years: 109.4 vs. 80.9 ng/ml; P=0.0001).
CONCLUSIONS: OPN plasma levels were increased in patients suffering from aCHF. OPN was associated with functional NYHA, structural AHA/ACC classification and left ventricular dysfunction. Increased levels of OPN might indicate patients with aCHF at higher functional or structural disease stages and might predict 1- and 5-year mortality in high risk aCHF patients.
- © 2012 by American Heart Association, Inc.