Abstract 12830: Circulating Thrombospondin-2 Reflects Disease Severity and Provides Prognostic Information in Patients with Reduced Left Ventricular Ejection Fraction
Introduction: Thrombospondin-2 (TSP-2) is a matricellular protein found in human serum. Recent work suggests that deletion of TSP-2 causes age-dependent dilated cardiomyopathy.
Hypothesis: TSP-2 could be a useful biomarker for disease severity and cardiovascular mortality in patients with left ventricular (LV) systolic dysfunction.
Methods and results: We measured serum TSP-2 levels in 101 patients with LV systolic dysfunction. LV systolic dysfunction was defined as LV ejection fraction of 50% or less. Serum TSP-2 concentrations were measured by ELISA. The endpoint of this study was a composite of total mortality and cardiovascular hospitalization. These patients were divided into 2 groups according to TSP-2 levels. Median TSP-2 levels in each group were 13.28 ng/ml and 22.95 ng/ml, respectively. High TSP-2 group revealed significantly higher BNP (median 324.8, interquartile range [179.9-641.3] vs. 105.5, [46.7-199.4] pg/ml, p≤0.0001), high sensitive C-reactive protein (0.12, [0.04-0.52] vs. 0.035, [0.02-0.089] mg/l, p=0.0006), high sensitive troponin T (0.020, [0.011-0.031] vs. 0.008, [0.005-0.014] ng/ml, p≤0.0001) levels than low TSP-2 group. Moreover, serum TSP-2 levels were positively correlated with NYHA functional class in this study population (p=0.017). Kaplan Meier curve revealed that the event-free rate was decreased in the high TSP-2 group (log-rank test p=0.032). Multivariate Cox hazard analysis identified presence of glucose intolerance (hazard ratio [HR]: 2.59; 95% confidence interval [CI]: 1.01-6.62, p=0.047), presence of anemia (hemoglobin ≤11.0g/dl) (HR: 2.80; 95% CI: 1.16-6.73, p=0.022), and TSP-2 (ln[TSP-2]) (HR: 4.08; 95% CI: 1.14-14.65, p=0.031) as independent predictors of mortality and cardiovascular events.
Conclusions: TSP-2 could be a useful biomarker for evaluating disease severity and providing prognostic information in patients with LV systolic dysfunction.
- © 2013 by American Heart Association, Inc.