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Ceruloplasmin, Catalase and Creatinine Concentrations Are Independently Associated with All-Cause Mortality in
Wiktoria Smyła-Gruca1, Wioletta Szczurek-Wasilewicz2, Michał Skrzypek3
1Student's Scientific Society, 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
Insights
In advanced heart failure (HF), lower levels of ceruloplasmin and catalase, and higher creatinine predict one-year mortality. These oxidative balance markers offer significant prognostic insights for HF patients.
Area of Science:
- Cardiology
- Biochemistry
- Biomarkers
Background:
- The role of oxidative and antioxidative system imbalances in advanced heart failure (HF) remains incompletely understood.
- Identifying reliable prognostic factors for one-year mortality in advanced HF is crucial for patient management.
Purpose of the Study:
- To investigate factors associated with one-year mortality in advanced HF patients.
- To specifically assess the prognostic value of oxidative/antioxidative balance parameters.
Main Methods:
- Analysis of 85 advanced heart failure patients undergoing right heart catheterization.
- Measurement of oxidative/antioxidative markers, including ceruloplasmin and catalase, from coronary sinus blood.
- Multivariable logistic regression and ROC analysis to determine associations with one-year mortality.
Main Results:
- One-year mortality rate was 40%.
- Lower ceruloplasmin and catalase levels in coronary sinus blood, and higher creatinine levels in peripheral blood were independently associated with one-year mortality.
- Catalase and ceruloplasmin demonstrated excellent prognostic power (AUC > 0.92), while creatinine showed acceptable power (AUC > 0.76).
Conclusions:
- Imbalances in the oxidative/antioxidative system, specifically lower ceruloplasmin and catalase, are significant predictors of mortality in advanced HF.
- Higher creatinine levels also independently predict mortality.
- These biomarkers can effectively distinguish one-year survivors from non-survivors in advanced HF populations.
Abstract:
The role of oxidative/antioxidative system imbalances in advanced heart failure (HF) has not been fully investigated. The aim of this study was to identify factors associated with one-year mortality in patients with advanced HF, with particular emphasis on oxidative/antioxidative balance parameters. We analyzed 85 heart transplant candidates who were hospitalized at our institution for right heart catheterization. Ten milliliters of coronary sinus blood was collected to measure oxidative/antioxidative markers. The median age was 58 (50-62) years, and 90.6% of them were male. The one-year mortality rate was 40%. Multivariable logistic regression analysis revealed that ceruloplasmin (OR = 1.342 [1.019-1.770], p = 0.0363; per unit decrease), catalase (OR = 1.053 [1.014-1.093], p = 0.0076; per unit decrease), and creatinine (OR = 1.071 [1.002-1.144], p = 0.0422; per unit increase) were independently associated with one-year mortality. Ceruloplasmin, catalase, and creatinine had areas under the curve of 0.9296 [0.8738-0.9855], 0.9666 [0.9360-0.9971], and 0.7682 [0.6607-0.8756], respectively. Lower ceruloplasmin and catalase in the coronary sinus, as well as higher creatinine in peripheral blood, are independently associated with one-year mortality in patients with advanced HF. Catalase and ceruloplasmin have excellent prognostic power, and creatinine has acceptable prognostic power, allowing the distinction of one-year survivors from nonsurvivors.
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