DO HIGH SENSITIVITY C-REACTIVE PROTEIN AND CYSTATIN-C SERUM LEVELS PREDICT TOTAL MORTALITY IN HEART FAILURE PATIENTS?
Abstract number: P-S-472
Gori1 A.M., Ognibene2 A., Marcucci1 R., Lenti1 M., Caldini2 A., Del Pace3 S., Nozzoli4 C., Verdiani4 V., Abbate1 R., Gensini1 G.F.
11Medical and Surgical Critical Area, University of Florence 22Central Laboratory 33Dipartimento of Heart and Vessels 44U.O. Medicina Generale, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
How-to-cite Gori AM, Ognibene A, Marcucci R, Lenti M, Caldini A, Del Pace S, Nozzoli C, Verdiani V, Abbate R, Gensini GF. DO HIGH SENSITIVITY C-REACTIVE PROTEIN AND CYSTATIN-C SERUM LEVELS PREDICT TOTAL MORTALITY IN HEART FAILURE PATIENTS?. J Thromb Haemost 2007; 5 Supplement 2: P-S-472
Abstract
Introduction: Arterial wall remodelling and atherogenesis are favoured by over-expression of elastolytic and collagenolytic cathepsins and by the reduction of their inhibitor Cystain C (Cys-C). In atherosclerotic lesions the elastolytic and collagenolytic cathepsins are over-expressed, whereas their endogenous inhibitor Cys-C resulted to be reduced.
Heart failure (HF) resulted to be associated with both inflammation and Cys-C, a novel endogenous marker of glomerular filtration rate.
Methods: Aim of this study was to evaluate hsC-reactive protein (hsCRP) and Cys-C levels in patients with HF and the role of Cys-C and inflammation in affecting the clinical outcome of HF. We studied 131 patients with HF (102 M/29 F), median age 74 (43-95 yrs) and 131 healthy subjects, comparable for age and sex. Cys-C and hs-CRP serum levels were assayed by nephelometric methods.
Results: After adjusting for age, sex, BMI and creatinine, Cys-C, as well as hsCRP serum concentrations were significantly higher in HF patients than in controls [Cys-C: 1.39(1.33-1.46) ng/mL vs 0.99 (0.95-1.04) ng/mL, p<0.001; hsCRP: 5.6 (4.6-6.9) mg/L vs 2.6(2.2-3.2) mg/L; for HF patients and controls respectively (p<0.0001)].HF patients were stratified into two groups based on their serum creatinine values [group A: patients with normal creatinine values; group B: patients with elevated creatinine values]. In group A, Cys-C levels, but not hsCRP levels, were significantly higher in HF patients who died with respect to survivors patients [Cys-C: 1.52(1.13-2.055) ng/mL vs 1.15(1.08-1.25) ng/mL, p<0.05; hsCRP: 2.26(1.96-2.61) mg/dL vs 2.29(1.71-3.04) mg/dL n.s.]. In group B, no significant difference in Cys-C and hsCRP levels between survivors and non-survivors HF patients was observed. In both group A and group B, Cys-C and hsCRP serum levels were not different in relation to re-hospitalization.
Conclusions: Our data suggest that elevated Cys-C values provide prognostic information for clinical outcome in HF with normal creatinine values.
