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Oxidative Stress and DNA Damage Biomarkers in Heart Failure: A Systematic Review and Meta-Analysis
Francesca Milani1,2, Annamaria Porreca1,2, Giuseppe Rosano1,3
1Department of Human Sciences and Quality of Life Promotion, San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy.
Antioxidants (Basel, Switzerland)
|October 29, 2025
Summary
Oxidative stress and DNA damage biomarkers are elevated in heart failure (HF) patients. This meta-analysis confirms their association with HF, suggesting their utility in monitoring disease progression and predicting outcomes.
Area of Science:
- Cardiology
- Biochemistry
- Genetics
Background:
- Oxidative stress is a critical factor in heart failure (HF) pathophysiology.
- It contributes to myocardial injury, inflammation, and adverse cardiac remodeling.
- The clinical significance of oxidative stress and DNA damage biomarkers in HF requires clarification.
Purpose of the Study:
- To systematically review and meta-analyze oxidative stress and DNA damage biomarkers in HF patients.
- To compare biomarker levels in HF patients versus healthy controls.
Main Methods:
- A systematic literature search was performed across major databases (PubMed, MEDLINE, Cochrane, Web of Science) following PRISMA guidelines.
- Random-effects models were employed to calculate ratios of means (ROM) with 95% confidence intervals (CI).
- Heterogeneity and publication bias were assessed using I² statistic and Begg's test.
Main Results:
- Analysis of 3015 HF patients and 2704 controls revealed significantly elevated 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), and isoprostanes in HF.
- HF patients exhibited significantly shorter telomere length, indicative of accelerated cellular aging.
- Substantial heterogeneity was noted among the included studies.
Conclusions:
- This meta-analysis provides strong evidence for an association between oxidative stress, DNA damage, and heart failure.
- These biomarkers show potential for monitoring HF progression and predicting patient prognosis.
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