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GlycA and GlycB as Inflammatory Markers in Chronic Heart Failure
German Cediel1, Albert Teis2, Pau Codina3
1Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain; Center for Biomedical Research on Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
Insights
New biomarkers for systemic inflammation, N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB), show prognostic value in nonischemic heart failure (HF). These markers predict adverse outcomes like death and HF readmission in this patient group.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation Research
Background:
- Inflammation plays a critical role in heart failure (HF) pathogenesis.
- The prognostic impact of inflammation may differ based on HF etiology.
- Novel biomarkers are needed to assess systemic inflammation in HF.
Purpose of the Study:
- To evaluate N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB) as biomarkers of systemic inflammation in chronic heart failure (HF).
- To determine the prognostic value of GlycA and GlycB for adverse outcomes in patients with chronic HF, considering etiology.
- To explore the association of these inflammatory markers with clinical parameters and HF readmissions.
Main Methods:
- Proton nuclear magnetic resonance spectroscopy was used to measure GlycA and GlycB levels in 429 patients with chronic HF.
- Patients were categorized by HF etiology (ischemic vs. nonischemic).
- The primary endpoint was a composite of all-cause death and HF readmission. Survival analysis and multivariable adjustments were performed.
Main Results:
- In patients with nonischemic HF, both GlycA and GlycB were significantly associated with the composite endpoint of death or HF readmission.
- GlycB levels were independently associated with HF readmission and recurrent HF-related admissions in nonischemic HF patients.
- No significant association between GlycA, GlycB, and clinical endpoints was observed in patients with ischemic HF.
Conclusions:
- GlycA and GlycB are emerging biomarkers reflecting systemic inflammation status in chronic heart failure.
- These markers possess significant prognostic value for long-term outcomes, particularly in patients with nonischemic HF.
- Inflammatory markers may have differential prognostic implications depending on the underlying cause of heart failure.
Abstract:
The role of inflammation in heart failure (HF) has been extensively described, but it is uncertain whether inflammation exerts a different prognostic influence according to etiology. We aimed to examine the inflammatory state in chronic HF by measuring N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB), evolving proton nuclear magnetic resonance biomarkers of systemic inflammation, and explore their prognostic value in patients with chronic HF. The primary end point was a composite of all-cause death and HF readmission. A total of 429 patients were included. GlycB correlated with interleukin-1 receptor-like 1 in the whole cohort (r2 = 0.14, p = 0.011) and the subgroup of nonischemic etiology (r2 = 0.31, p <0.001). No association was found with New York Heart Association functional class or left ventricular ejection fraction. In patients with nonischemic HF (52.2%, n = 224), GlycA and GlycB exhibited significant association with the composite end point (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.06 to 1.33, p = 0.004 and HR 2.13, 95% CI 1.43 to 3.13, p <0.001; respectively) and GlycB with HF readmission after multivariable adjustment (HR 2.25, 95% CI 1.54 to 3.30, p <0.001). GlycB levels were also associated with a greater risk of HF-related recurrent admissions (adjusted incidence rate ratio 1.33, 95% CI = 1.07 to 1.65, p = 0.009). None of the markers were associated with the clinical end points in patients with ischemic HF. In conclusion, GlycA and GlycB represent an evolving approach to inflammation status with prognostic value in long-term outcomes in patients with nonischemic HF.
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