P4380Prognostic impact of new humoral substances in chronic heart failure

Abstract

Aim: To evaluate the impact of new humoral substances on one year survival of patients with stable systolic chronic heart failure (CHF). Methods: The FAR NHL (FARmacology and NeuroHumoraL activation) registry is a database of patients treated in departments with specialized HF care in three University hospitals. Anamnestic data were prospectivelly collected from November 2014 till November 2015. The patients should be treated for systolic heart failure (EF <50%) and stable for at least one month, follow up was one year. Copeptin, mid regional‐proadrenomedullin (MR‐pADM), galectin3, NGAL, soluble lectin‐like oxidized LDL receptor‐1 (sLOX‐1), pentraxin 3 ((PTX3) and 3‐Nitrotyrosine (3‐NT) were measured. Primary endpoint after 1 year follow‐up was: death or hospitalization for decompensation of HF or heart transplantation or LVAD implantation. Results: 1050 patients were included, mean age 65 years, 80.8% were male. The etiology of CHF was ischemic heart disease in 49.4%, dilated cardiomyopathy in 42.3% and 8.3% were classified as other. Mean EF was 30%, median of blood pressure was 128/80 mmHg, median of heart rate 72 13.0% were classified as NYHA I, 61.3% NYHA II and 24.7% as NYHA III and IV. Patients without primary endpoint (death or hospitalization for decompensation of HF or heart transplantation or LVAD implantation) were assigned as group A (906 pts), those with the primary endpoint group B (144 pts). There were statistically significant differences between the groups in the levels of copeptin: group A median 15.9 pmol/l (3.4‐50.9) vs group B 23.7 pmol/l (5.0‐89.44) (p<0.001), MR‐pADM: group A median 0.63 nmol/l (0.32‐1.34) vs group B 0.74 nmol/l (0.4‐1.94) (p<0.001) and PTX3 group A median 0.7ng/ml (0.24‐2.79) and group B 0.9 ng/ml (0.37‐ 44.07) (p<0.001). There were no differences between the groups in other substances: galectin3, NGAL, sLOX‐1 and 3‐NT. Copeptin had sensitivity 50.6% and specificity 73.4%, MR‐pADM 78.3% and 43.5%, PTX3 93.9% and 35.2% respectively. Summary: Higher levels of new humoral substances: copeptin, MR‐pADM and PTX3 might identify HF patients with higher risk of adverse outcome, while galectin3, NGAL, sLOX‐1 and 3‐NT were not predictive for further prognosis of stable HF patients.