Abstract 12899: Predictive Value of Markers of Collagen Turnover for Systolic and Diastolic Heart Failure: The MESA Study
Introduction: Markers of collagen turnover have prognostic value in heart failure (HF), but the predictive value of these markers for incident heart failure in asymptomatic subjects is unknown.
Hypothesis: Collagen turnover markers (Procollagen Type III N-Terminal Propeptide (PIIINP) and Collagen Type I Carboxy-Terminal Telopeptide (ICTP)) may be associated with new onset of HF (total, systolic and diastolic HF) in subjects free of overt cardiovascular disease (CVD) at baseline.
Methods: We used a nested case-control design in a multi-ethnic sample of 3147 subject initially aged 45-84 years and free of CVD. We assayed baseline serum PIIINP and ICTP concentrations using radio-immunoassay. Incident HF (n=196) was based on medical records through a median 12.1 years of follow-up. Systolic HF (HFrEF) was defined if ejection fraction (EF) < 45 % and diastolic HF (HFpEF) if EF ≥ 45%. Poisson regressions were calculated using 2 models, adjusting for 1. Demographics (demog.) and estimated glomerular filtration (eGFrR) because ICTP is cleared by the kidney; 2. Model 1 + classical cardiovascular risk factors, and blood pressure and cholesterol lowering medication.
Results: Mean (SD) ICTP was 3.38 ± 1.77 μg/L and Mean (SD) PIIINP was 5.48 ± 2.04 μg/L. Among 196 new HF cases, 95 were systolic HF (HFrEF) and 86 were diastolic HF (HFpEF); the 15 HF cases with no ejection fraction recorded were omitted from subtype analysis. In Poisson regression during 12.1 year follow-up (Table 1), Model 1 associations of ICTP and PIIINP with total HF and HFpEF were substantially attenuated in Model 2, although PIINP remained significantly associated with HFpEF.
Conclusion: PIIINP as a marker of collagen turnover is predictive for incident HFpEF, in initially asymptomatic subjects free of overt cardiovascular disease, independently of classical cardiovascular risk factors.
Author Disclosures: D. Duprez: None. M. Gross: None. J.R. Kizer: Ownership Interest; Significant; Gilead Sciences, Inc; Pfizer, Inc. J.I. Ix: None. W.G. Hundley: None. D.R. Jacobs: None.
- © 2016 by American Heart Association, Inc.