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Circulating glypican-4 is a new predictor of all-cause mortality in patients with heart failure
Axel Muendlein1, Christine Heinzle2, Andreas Leiherer3
1Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria.
Insights
Serum glypican-4 (GPC4) independently predicts mortality in heart failure patients. This blood biomarker offers improved risk assessment, even outperforming NT-proBNP in predicting two-year survival.
Area of Science:
- Cardiology
- Biomarker Discovery
- Prognostics
Background:
- Heart failure presents a significant morbidity and mortality burden.
- Current risk prediction models for heart failure patients have limitations.
- Blood-based biomarkers show promise for enhancing clinical risk assessment.
Purpose of the Study:
- To investigate the impact of serum glypican-4 (GPC4) on mortality in patients with heart failure.
- To determine if GPC4 can serve as an independent predictor of all-cause mortality in this population.
Main Methods:
- Prospective cohort study involving 288 heart failure patients.
- Measurement of serum GPC4 levels at baseline using enzyme-linked immunosorbent assay.
- Recording of all-cause mortality over a 24-month follow-up period.
Main Results:
- Serum GPC4 significantly predicted all-cause mortality (HR per doubling = 3.57, P < 0.001).
- GPC4 association with mortality was significant in both reduced and preserved ejection fraction subgroups.
- GPC4 demonstrated additional prognostic value beyond NT-proBNP for predicting two-year mortality (P = 0.030).
Conclusions:
- Circulating GPC4 is an independent predictor of all-cause mortality in heart failure patients.
- Serum GPC4 has potential as a valuable biomarker for risk stratification in heart failure management.
Background:
Heart failure confers a high burden of morbidity and mortality. However, risk prediction in heart failure patients still is limited. Blood-based biomarkers hold promise to improve clinical risk assessment. Recently we have identified circulating glypican-4 (GPC4) as a significant predictor of mortality in coronary angiography patients and patients with peripheral artery disease. The impact of serum GPC4 on mortality in patients with heart failure is unknown and is addressed in this prospective cohort study.
Methods:
We prospectively recorded all-cause mortality in 288 patients with heart failure. GPC4 levels were measured using an enzyme-linked immunosorbent assay at baseline.
Results:
During the 24-month follow-up period, 28.1% (n = 81) of the patients died. Serum GPC4 significantly predicted all-cause mortality (hazard ratio (HR) per doublingof GPC4 = 3.57 [2.31-5.53]; P < 0.001). Subgroup analysis showed that GPC4 was significantly associated with all-cause mortality in patients with reduced ejection fraction (HR per doubling = 3.25 [1.75-6.04]; P < 0.001) as well as in those with preserved ejection fraction (HR per doubling = 3.07 [1.22-7.70]; P = 0.017). The association between serum GPC4 and all-cause mortality remained significant in multivariable Cox regression analysis correcting for traditional risk factors (P = 0.035). Results from C-statistics indicated an additional prognostic value of GPC4 relative to NT-proBNP for the prediction of two-year all-cause mortality (P = 0.030).
Conclusion:
Circulating GPC4 independently predicts all-cause mortality in patients with heart failure.
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