Pregnancy-associated plasma protein-A (PAPP-A) and the proform of the eosinophil major basic protein (ProMBP) are associated with increased risk of death in heart failure patients
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Risk stratification and patient management in heart failure (HF) is difficult due to the unpredictable progression of the disease, necessitating the development of reliable diagnostic biomarkers to facilitate decision-making in clinical practice. Pregnancy-associated plasma protein-A (PAPP-A) is a marker of arteriosclerotic heart disease. PAPP-A is a serum protease, which is involved in the insulin-like growth factor 1 (IGF-1) axis where it is inhibited by the proform of the eosinophil major basic protein (proMBP). In this study, we evaluated serum PAPP-A and proMBP as long-term prognostic biomarkers of all-cause mortality in HF. Serum PAPP-A and proMBP concentrations were determined in 683 patients with NYHA III-IV HF recruited in the EchoCardiography and Heart Study (ECHOS) in Denmark. The mean age of the patients (73% male) was 70 at admission. During 7 years of follow-up, 516 patients died. In univariate analysis, both PAPP-A and proMBP, divided into quartiles, showed significant association with mortality. Using a Cox proportional hazard model, hazard ratios for continuous values of PAPP-A and proMBP were HR = 1.42 (CI = 1.23-1.64, p < 0.0001) and HR = 1.36 (CI = 1.22-1.51, p <0.0001), respectively. However, neither PAPP-A nor proMBP were significant independent predictors when the model included age, gender, brain-type natriuretic peptide, medical history of HF, ischemic heart disease, chronic obstructive pulmonary disease, and diabetes mellitus. In conclusion, high levels of PAPP-A and proMBP are associated with increased risk of death from all causes in HF and are potential prognostic markers of adverse outcomes in HF patients.
Original language | English |
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Journal | Scandinavian Journal of Clinical & Laboratory Investigation |
Volume | 77 |
Issue number | 5 |
Pages (from-to) | 352-357 |
ISSN | 0036-5513 |
DOIs | |
Publication status | Published - 2017 |
- Aged, Aged, 80 and over, Analysis of Variance, Biomarkers/blood, Diabetes Mellitus/physiopathology, Echocardiography, Eosinophil Major Basic Protein/blood, Female, Follow-Up Studies, Heart Failure/blood, Humans, Insulin-Like Growth Factor I/metabolism, Male, Middle Aged, Myocardial Ischemia/physiopathology, Natriuretic Peptide, Brain/blood, Pregnancy, Pregnancy-Associated Plasma Protein-A/metabolism, Prognosis, Proportional Hazards Models, Protein Precursors/blood, Pulmonary Disease, Chronic Obstructive/physiopathology, Risk Factors
Research areas
ID: 197003068