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Predictive value of advanced glycation end products for the development of post-infarction heart failure: a
Sergio Raposeiras-Roubín1, Bruno K Rodiño-Janeiro, Beatriz Paradela-Dobarro
1Instituto de Investigación Sanitaria Santiago de Compostela, Santiago de Compostela, Spain.
Insights
Advanced glycation end products (AGE) are independent predictors of post-infarction heart failure (HF). Higher AGE levels significantly increase the risk of developing HF after a heart attack.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Medicine
Background:
- Post-infarction heart failure (HF) is a major cause of morbidity and mortality.
- Advanced glycation end products (AGE) play a role in myocardial dysfunction.
- Predicting post-infarction HF is crucial for patient outcomes.
Purpose of the Study:
- To investigate the prognostic value of AGE in predicting the development of post-infarction HF.
- To determine if AGE are independent predictors of HF after acute coronary syndrome.
Main Methods:
- A prospective study of 194 patients post-myocardial infarct.
- Measured fluorescent AGE levels and assessed glycaemic parameters.
- Utilized Cox regression multivariate analysis to identify independent predictors over a 1-year follow-up.
Main Results:
- 5.6% of patients developed HF within one year.
- While glucose, fructosamine, and HbA1c were initially predictive, only AGE, NT-proBNP, and infarct size remained significant after adjustment.
- Elevated AGE levels (above median) increased HF risk fivefold (HR 1.016, p<0.001).
Conclusions:
- Advanced glycation end products (AGE) serve as an independent risk marker for post-infarction HF development.
- AGE measurement can aid in risk stratification for patients following myocardial infarction.
Background:
Since post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development.
Methods:
A prospective clinical study in patients after first acute coronary syndrome was conducted. The follow-up period was consisted in 1 year. In 194 patients consecutively admitted in the coronary unit for myocardial infarct fluorescent AGE levels were measured. The association between glycaemic parameters and the development of post-infarction HF were analyzed in those patients. Finally, we identified the variables with independent predictor value by performing a multivariate analysis of hazard ratio for Cox regression.
Results:
Eleven out of 194 patients (5.6%) developed HF during follow-up (median: 1.0 years [0.8 - 1.5 years]). Even though basal glucose, fructosamine and glycated haemoglobin were significant predictive factors in the univariate analysis, after being adjusted by confounding variables and AGE they lost their statistical signification. Only AGE (Hazard Ratio 1.016, IC 95%: 1.006-1.026; p<0,001), together with NT-proBNP and the infarct extension were predictors for post-infarction HF development, where AGE levels over the median value 5-fold increased the risk of HF development during follow-up.
Conclusions:
AGE are an independent marker of post-infarction HF development risk.
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