Abstract 18269: Prognostic Value of Insulin-Like Growth Factor Binding Protein 7 (IGFBP7) in Patients With Heart Failure: Data From CORONA
Background: A recent proteomic analyses of cardiac tissue from a transgenic murine model of heart failure (HF) and clinical myocardial samples identified IGFBP7 as a candidate marker of HF. We investigated if serum levels of IGFBP7 were upregulated in human HF, if IGFBP7 provided independent prognostic information in these patients, and potential interactions with statin therapy.
Materials and methods: Serum IGFBP7 was measured in 187 HF patients and 57 matched healthy controls. The associations of serum IGFBP7 with adverse outcome were assessed in a subset of 1428 patients enrolled in the in the Controlled Rosuvastatin Multinational Trial in HF (CORONA) population, randomly assigned to 10 mg rosuvastatin or placebo, which included patients with HF, aged ≥60 years, in New York Heart Association classes II to IV, who had ischemic heart disease and a reduced left ventricular ejection fraction. Outcome included the primary endpoint (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke; n=408), all-cause mortality (n=422), CV mortality (n=344), coronary endpoint (n=330) and CV mortality/hospitalization for worsening of heart failure (n=535).
Results: Serum IGFBP-7 levels were markedly elevated (p<0.001) in HF patients compared to controls (median [25th, 75th percentile]: 694 [586,874] ng/mL vs. 458 [425,499] ng/mL, p<0.001) and correlated with clinical severity (i.e. NYHA, p=0.002). In univariate analyses, IGFBP7 (continuous variable) was associated with all outcomes [HR ranging from 1.76 (coronary endpoint, p=0.003) to 3.08 (CV death, p<0.001)]. In multi-variable analyses, IGFBP7 remained significant for most endpoints after step 1 adjustment (adjusting for left ventricular ejection fraction, NYHA class, age, body mass index, diabetes, sex, intermittent claudication, heart rate, serum creatinine and apoA1) but the predictive value was markedly attenuated and not significant for any outcome after the addition of CRP and NT-proBNP. No interaction by treatment effects were observed for any outcome.
Conclusions: Serum IGFBP7 levels are elevated in patients with HF but add no predictive information beyond NT-proBNP for adverse outcome in older patients with advanced chronic systolic HF of ischemic aetiology.
- © 2013 by American Heart Association, Inc.