Circulating thrombospondin-2 in patients with moderate-to-severe chronic heart failure due to coronary artery disease

E Alexander,A Alexander,A Tatayna

doi:10.7555/jbr.30.20140025

Abstract

Chronic heart failure (CHF) remains a leading cause of morbidity and mortality. In the current study, we aimed to evaluate the predictive value of circulating thrombospondin-2 (TSP-2) for cumulative survival in patients with ischemic CHF due to coronary artery disease (CAD). The results showed that during a median follow-up of 2.18 years, 21 participants died and 106 subjects were hospitalized repeatedly. The median circulating levels of TSP-2 in patients who survived and those who died were 0.63 ng/mL (95%CI = 0.55-0.64 ng/mL) and 1.03 ng/mL (95% CI = 0.97-1.07 ng/mL) (P<0.001). Circulating TSP-2 independently predicted all-cause mortality (OR = 1.27; 95%CI = 1.08–1.59; P = 0.002), CHF-related death (OR = 1.16; 95%CI = 1.02–1.50; P<0.001), and also CHF-related rehospitalization (OR = 1.12; 95%CI = 1.07–1.25; P<0.001). In conclusion, among CAD patients with symptomatic CHF, increased circulating TSP-2 is correlated with increased 3-year CHF-related death, all-cause mortality, and risk for recurrent hospitalization.

Highlights

Chronic heart failure (CHF) remains a leading cause of morbidity and mortality worldwide[1]
The natural evolution of CHF is associated with endothelial dysfunction that results in shear stress disorders on endothelium which is exerted by several factors, such as angiotensin-aldosterone system activation, oxidative stress, proinflammatory response, exaggerated collagen synthesis and extracellular matrix (ECM) remodelling in vasculature, and degradation of vasodilators[2]
The patients were comparable in baseline characteristics including body mass index (BMI), Glomerular filtration rate (GFR), HbA1c, fasting blood glucose level, blood creatinine level, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), and the number of damaged coronary vessels

Summary

Introduction

Chronic heart failure (CHF) remains a leading cause of morbidity and mortality worldwide[1]. Thrombospondin-2 (TSP-2) is an important component that influences the function of vascular smooth muscle cells, endothelial cells, fibroblasts and inflammatory cells, as well as modulates the survival of endothelial cells and myocytes with important implications for CHF evolution[3,4]. It has been reported that increased TSP-2 associates well with the severity of diastolic heart failure and predicts mortality in patients with preserved left ventricular ejection fraction[9]. This suggests that TSP-2 might be considered as a marker of the natural evolution of CHF irrespectively related with worsening endothelial function. The objective of the study was to evaluate the predictive value of circulating TSP-2 for cumulative survival in patients with symptomatic CHF due to coronary artery disease (CAD)

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Results

Conclusion