Abstract 13809: Serial Paraoxonase-1-associated Serum Arylesterase Activity and Outcomes in Ambulatory Patients With Heart Failure
Introduction: Decreased arylesterase (ArylE) activity of paraoxonase-1, a HDL-associated protein with anti-inflammatory and antioxidant properties, has been associated with increased risk of cardiac events in ischemic heart failure (HF) patients. However, the change of ArylE activity over time and its association with HF adverse outcomes has not been reported.
Methods: We examined the association between baseline and follow up serum ArylE activity and HF outcomes (death, cardiac transplantation or ventricular assist device implantation) in 304 patients with HF enrolled in the Atlanta Cardiomyopathy Consortium, a prospective cohort study in the metropolitan Atlanta GA area from 1/2008 to 7/2009. ArylE activity was assessed on enrollment for all patients, and for 152 patients after 1 year of follow up. Significant drop in ArylE activity on follow up was defined as a drop of ≥25% vs. baseline levels.
Results: In our population (age 56.5±12 years, male 63.9%, CAD 39.1%, EF 30±15 %), mean baseline and follow up ArylE activity levels were 110.5 ± 29.8 μmol/min/ml and 105.2±27.7 μmol/min/ml, respectively. Mean ArylE activity change between follow up and baseline levels was -5.9 ± 28.6 μmol/min/ml, p = 0.015. After mean follow up of 2.8 ± 1.1 years, 53 events were reported. Low baseline ArylE activity was associated with increased risk of adverse HF outcomes [HR (95CI%) for lowest tertile vs highest tertile of 2.6 (1.3-5.5), p=0.01] (Figure A). This association remained significant after adjustment for age, gender, diabetes, creatinine clearance and CAD. Patients who had significant drop in ArylE activity (≥25% of baseline levels, n=18), had significantly increased risk of HF events [HR(95%CI) of 4.9 (1.6-14.6), p=0.005], even after adjustment for baseline levels of ArylE activity (Figure B).
Conclusions: Reduced baseline ArylE activity and decreased levels on follow up are associated with adverse outcomes in stable outpatients with HF.
Author Disclosures: M. Hammadah: None. A.P. Kalogeropoulos: None. V. Georgiopoulou: None. M. Weber: None. Y. Wu: None. J. Butler: None. W. Tang: None.
- © 2015 by American Heart Association, Inc.