Serum Chemerin as a Novel Prognostic Indicator in Chronic Heart Failure

Abstract

Background: It has been documented that circulating chemerin is associated with inflammation, metabolic syndrome, and coronary artery disease. The present study was aimed to evaluate the prognostic value of serum chemerin in patients with chronic heart failure. Methods and Results: We included 834 patients with chronic heart failure in a prospective cohort study and investigated the association between serum chemerin and clinical outcomes using multivariate Cox regression analysis. Patients with higher chemerin levels tended to be older and women and were more likely to experience hypertension, diabetes mellitus, and hyperlipemia. Cox regression analysis showed that chemerin was a significant predictor of major adverse cardiac events (hazard ratio, 1.83; 95% CI, 1.31–2.96) after adjustment for conventional risk factors. Net reclassification and integrated discrimination improvements for major adverse cardiac events were markedly improved by addition of chemerin to the reference model. In addition, chemerin was an independent predictor of all-cause mortality (hazard ratio, 1.67; 95% CI, 1.21–2.73) after multivariable adjustment. Furthermore, the Kaplan–Meier survival analysis revealed that chemerin was a prognostic indicator of major adverse cardiac events in patients with chronic heart failure and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels above and below the median. Conclusions: Our study suggests that chemerin is a novel serum marker for predicting major adverse cardiac events in patients with chronic heart failure.