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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Predictive value of endostatin in chronic heart failure patients with poor kidney function
Thor Ueland1, Pål Aukrust, Ståle H Nymo
1Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Insights
Serum endostatin did not predict adverse outcomes in chronic heart failure (HF) patients. However, high endostatin levels were linked to increased mortality risk in those with reduced renal function.
Area of Science:
- Cardiovascular Research
- Nephrology
- Biomarker Discovery
Background:
- Elevated endostatin levels are observed in progressive cardiovascular (CV) and renal diseases.
- Endostatin's role in chronic heart failure (HF) and its association with renal function require further investigation.
Purpose of the Study:
- To assess the predictive value of serum endostatin in patients with chronic systolic HF.
- To examine the relationship between endostatin levels and estimated glomerular filtration rate (eGFR) in HF patients.
Main Methods:
- Analysis of 1,390 patients aged over 60 with ischemic systolic HF from the CORONA trial.
- Evaluation of serum endostatin interaction with eGFR and predefined clinical endpoints (CV death, myocardial infarction, stroke, all-cause mortality).
Main Results:
- Serum endostatin did not provide additional predictive information for adverse outcomes after multivariable adjustment including eGFR.
- A strong positive correlation was found between serum endostatin and eGFR (r = 0.59, p < 0.001).
- High endostatin was associated with increased all-cause mortality in HF patients with impaired renal function and decreased risk of primary/coronary endpoints in those with preserved renal function.
Conclusions:
- Endostatin lacks predictive value for adverse outcomes in ischemic systolic HF.
- Reduced renal function in HF patients is associated with an increased risk of all-cause mortality when endostatin levels are high.
Objectives:
Increased circulating endostatin levels have been demonstrated in progressive cardiovascular (CV) and renal disorders. We investigated the predictive value of endostatin in patients with chronic heart failure (HF) and the association between endostatin and renal function.
Methods:
The interaction between serum endostatin, estimated glomerular filtration rate (eGFR) and predefined endpoints, including the primary endpoint (CV death, nonfatal myocardial infarction, nonfatal stroke; n = 397), all-cause mortality (n = 410), CV death (n = 335) or the coronary endpoint (n = 317), was evaluated in 1,390 patients >60 years of age with ischemic systolic HF in the Controlled Rosuvastatin Multinational Trial in HF (CORONA) population, who were randomly assigned to 10 mg rosuvastatin or placebo.
Results:
In the population as a whole, endostatin added no predictive information after full multivariable adjustment including eGFR and N-terminal pro-brain natriuretic peptide. Serum endostatin was strongly correlated with eGFR (r = 0.59, p < 0.001). After full multivariable adjustment, an association between high serum endostatin and increased risk of all-cause mortality and decreased risk of the primary and coronary endpoints was seen in HF patients with impaired and preserved renal function, respectively.
Conclusions:
Endostatin added no predictive information regarding the adverse outcome in patients with chronic systolic HF of ischemic etiology. An increased risk of all-cause mortality was seen in patients with decreased renal function.
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