Abstract 13324: TRACP5b, a Marker of Osteoporosis, is Associated With Adverse Cardiac Events in Hospitalized Patients With Heart Failure

Abstract

Introduction: Tarterate-resistant acid phosphatase type 5b (TRACP5b) is derived from osteoclast, and has been used as a maker of osteoporosis. Although heart failure (HF) is associated with catabolic bone remodeling, serum TRACP5b levels have not been rigorously examined in patients with HF. Methods and Results: We conducted a prospective observational study of 688 decompensated HF patients, and patients were divided into tertiles based on serum TRACP5b levels: 1 st (TRACP5b <316 mU/dL, n = 229), 2 nd (316 ≤ TRACP5b <490 mU/dL, n = 229), and 3 rd (490 mU/dL ≤ TRACP5b, n = 230) tertiles. We compared baseline patients’ characteristics and their post-discharge prognosis including cardiac mortality and cardiac events such as cardiac death and worsening HF. Age was significantly higher, and prevalence of female and anemia was significantly higher in the 3 rd tertile than in the 1 st and 2 nd tertiles (age, 71.9 vs. 64.2 and 67.3 years, P<0.001; female, 50.4% vs. 35.4% and 43.2%, P=0.005; anemia, 54.8% vs. 41.9% and 46.7%, P=0.021). In contrast, left ventricular ejection fraction, prevalence of hypertension, diabetes, chronic kidney disease and atrial fibrillation did not differ among the tertiles. In the Kaplan-Meier analysis ( Figure , mean follow up of 426 days), cardiac mortality and cardiac event rates progressively increased from the 1 st to the 3 rd tertiles (cardiac mortality, 3.1%, 5.2% and 8.7%, log-rank P =0.024; cardiac event rates, 10.9%, 14.0% and 20.4%, log-rank P=0.010). In the multivariable Cox proportional hazard analysis, the 3 rd tertile was found to be an independent predictor of cardiac mortality and cardiac events (cardiac mortality, hazard ratio 1.381, P=0.035; cardiac events, hazard ratio 1.664, P=0.044). Conclusion: High serum levels of TRACP5b, a marker of osteoporosis, is associated with adverse prognosis in HF patients.