Complement Components sC5b-9 and CH50 Predict Prognosis in Heart Failure Patients Combined With Hypertension

Area of Science:

• Cardiovascular Medicine
• Immunology
• Biochemistry

Background:

• Heart failure (HF) significantly impacts quality of life and survival, often stemming from inflammation and vascular injury.
• The complement system is crucial for maintaining vessel integrity and regulating inflammatory responses.
• The prognostic significance of serum complement levels in HF, particularly in hypertensive patients, remains incompletely understood.

Purpose of the Study:

• To investigate the association between complement system activation markers and the prognosis of heart failure in patients with hypertension.
• To identify independent risk factors for overall survival (OS) in this patient cohort.
• To develop and validate a nomogram for predicting OS risk.

Main Methods:

• A cohort of 263 newly diagnosed hypertension patients with HF was studied.
• Plasma levels of complement components (C3a, C3b, C5a, sC5b-9) and total hemolytic complement (CH50) were measured.
• Classical cardiovascular risk factors were collected, and statistical analyses, including multivariate regression and nomogram construction, were performed to assess prognostic value.

Main Results:

• Hypertension patients with HF exhibited significantly elevated plasma levels of C5a, sC5b-9, and CH50 compared to controls.
• Independent risk factors for worsened OS included hyperlipidemia, elevated N-terminal pro-Brain Natriuretic Peptide (NT-pro-BNP), high sC5b-9, and high CH50 levels.
• A nomogram incorporating these factors demonstrated good accuracy in predicting OS, with a bootstrap-corrected C-index of 0.789.

Conclusions:

• Elevated sC5b-9 and CH50 levels are associated with increased risk and poorer prognosis in hypertensive patients with heart failure.
• A multivariate-analysis-based nomogram provides a reliable tool for estimating overall survival risk in this population.