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Serum Activin A Level and 1-Year Mortality in Atrial Septal Defect-Associated Pulmonary Artery Hypertension: A
Pranindya Rinastiti1,2, Anggoro Budi Hartopo1, Cindy Elica Cipta1
1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada-Dr. Sardjito Hospital, Yogyakarta, Indonesia, ugm.ac.id.
Insights
Serum activin A levels did not predict 1-year mortality in patients with atrial septal defect-associated pulmonary artery hypertension (ASD-PAH). This finding suggests activin A is not a reliable prognostic biomarker for this specific patient group.
Area of Science:
- Cardiology
- Pulmonology
- Biomarker Research
Background:
- Pulmonary artery hypertension (PAH) associated with atrial septal defect (ASD-PAH) presents unique challenges in prognosis.
- Serum activin A has emerged as a potential prognostic biomarker in various cardiovascular conditions.
Purpose of the Study:
- To investigate the association between serum activin A levels and 1-year mortality in adult patients with ASD-PAH.
- To determine if serum activin A can serve as a prognostic biomarker for ASD-PAH patients.
Main Methods:
- A case-control study was conducted using data from the COHARD-PH registry.
- Patients were categorized into cases (deceased within 1 year) and controls (survived 1 year).
- Serum activin A levels were measured at diagnosis, with clinical, hemodynamic, and mortality data analyzed.
Main Results:
- No significant difference in serum activin A levels was observed between deceased and survived ASD-PAH patients.
- Serum activin A levels did not correlate with 1-year mortality risk in the studied cohort.
- Deceased patients exhibited lower body weight, BMI, TAPSE, and higher NT-proBNP, Eisenmenger syndrome proportion, RA area, and mRAP.
Conclusions:
- Serum activin A levels are not associated with 1-year mortality in adult patients with ASD-associated PAH.
- Activin A may not be a suitable prognostic biomarker for this specific PAH subgroup.
Background:
Serum activin A level is a promising prognostic biomarker for pulmonary artery hypertension (PAH). In this study, we aim to investigate serum activin A levels and their associations with 1-year mortality in atrial septal defect (ASD)-associated PAH patients.
Methods:
This was a case-control study of adult Indonesian patients diagnosed with ASD-PAH from the COHARD-PH registry. Cases were subjects deceased in a 1-year follow-up, whereas controls were those survived. Serum activin A was measured at the index of diagnosis. The demographics, clinical parameters, hemodynamic, and mortality data were retrieved from the registry database up to a 1-year follow-up period. These data were compared and analyzed between the case and control groups.
Results:
From the 1-year follow-up data, 44 cases (deceased group) and 102 controls (survived group) were identified. The deceased group had significant lower bodyweight (p < 0.001), body mass index (BMI) (p < 0.01), with higher NT-proBNP level (< 0.0001), higher proportion of Eisenmenger syndrome (p < 0.05), higher right atrial (RA) area (p < 0.0001), lower tricuspid annular plane systolic excursion (TAPSE) (p < 0.01), and a significant increase in mean right atrial pressure (mRAP) (< 0.0001). There was no difference in the activin A level between deceased and survivors (506.3 ± 259.1 pg/mL vs. 536.1 ± 293.9 pg/mL, p > 0.05, respectively). Moreover, activin A level did not associate with the mortality risk among subjects (OR = 0.9996; 95% CI: 0.9982-1.00087; p > 0.05).
Conclusion:
Serum activin A level did not associate with 1-year mortality in adult patients with ASD-associated PAH.
