Prognostic Value of Insulin-Like Growth Factor-Binding Protein 7 in Patients with Heart Failure and Preserved Ejection Fraction

Autor: Robert S. McKelvie, Inder S. Anand, Sheryl L. Chow, Michel Komajda, Thomas S. Rector, Parul U. Gandhi, Hanna K. Gaggin, Michael R. Zile, John J.V. McMurray, Henry Krum, Peter E. Carson, James L. Januzzi
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Time Factors
IGFBP7
Tetrazoles
030204 cardiovascular system & hematology
Insulin-like growth factor-binding protein
03 medical and health sciences
0302 clinical medicine
Irbesartan
Primary outcome
Risk Factors
Cause of Death
Internal medicine
medicine
Humans
In patient
030212 general & internal medicine
Aged
Heart Failure
Ejection fraction
biology
business.industry
Biphenyl Compounds
biomarkers
Stroke Volume
preserved left ventricular function
Prognosis
medicine.disease
United States
Hospitalization
Insulin-Like Growth Factor Binding Proteins
Survival Rate
Increased risk
Heart failure
biology.protein
Cardiology
insulin-like growth factor-binding protein 7
Female
Cardiology and Cardiovascular Medicine
business
Angiotensin II Type 1 Receptor Blockers
Follow-Up Studies
medicine.drug
Zdroj: Journal of Cardiac Failure. 23:20-28
ISSN: 1071-9164
DOI: 10.1016/j.cardfail.2016.06.006
Popis: Background: The prognostic merit of insulin-like growth factor-binding protein 7 (IGFBP7) is unknown in heart failure and preserved ejection fraction (HFpEF). Methods and Results: Baseline IGFBP7 (BL-IGFBP7; n = 302) and 6-month change (Δ; n = 293) were evaluated in the Irbesartan in Heart Failure and Preserved Ejection Fraction (I-PRESERVE) trial. Primary outcome was all-cause mortality or cardiovascular hospitalization with median follow-up of 3.6 years; secondary outcomes included HF events. Median BL-IGFBP7 concentration was 218 ng/mL. BL-IGFBP7 was significantly correlated with age (R2 = 0.13; P < .0001), amino-terminal pro-B-type NP (R2 = 0.22; P < .0001), and estimated glomerular filtration rate (eGFR; R2 = 0.14; P < .0001), but not with signs/symptoms of HFpEF. BL-IGFBP7 was significantly associated with the primary outcome (hazard ratio [HR] = 1.007 per ng/mL; P < .001), all-cause mortality (HR = 1.008 per ng/mL; P < .001), and HF events (HR = 1.007 per ng/mL; P < .001). IGFBP7 remained significant for each outcome after adjustment for ln amino-terminal pro-B-type NP and eGFR but not all variables in the I-PRESERVE prediction model. After 6 months, IGFBP7 did not change significantly in either treatment group. ΔIGFBP7 was significantly associated with decrease in eGFR in patients randomized to irbesartan (R2 = 0.09; P = .002). ΔIGFBP7 was not independently associated with outcome. Conclusions: Higher concentrations of IGFBP7 were associated with increased risk of cardiovascular events, but after multivariable adjustment this association was no longer present. Further studies of IGFBP7 are needed to elucidate its mechanism.
Databáze: OpenAIRE
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