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Serum soluble E-selectin and NT-proBNP levels additively predict mortality in diabetic patients with chronic heart failure

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Abstract

Background

Neuroendocrine activation with endothelial dysfunction is a key pathophysiological process in chronic heart failure (CHF). Although increased soluble E-selectin (sE-selectin) levels predict adverse events in several forms of cardiovascular disease, there are only scarce data on its predictive value in CHF. The aim of our study was to investigate whether sE-selectin is a useful predictor of mortality in CHF patients and whether its predictive power is additive to that of NT-proBNP.

Methods

Plasma levels of sE-selectin were measured by ELISA in 192 CHF patients with clinical systolic heart failure. The study population was followed up for 14.9 months on average; 46 patients died during this period.

Results

Levels of sE-selectin were significantly higher in non-surviving patients than in survivors (p = 0.005) and significantly correlated with the following inflammatory markers: CRP (r = 0.242, p = 0.001), TNF-α (r = 0.201, p = 0.005), TNF-RII (r = 0.207, p = 0.004), and IL-6 (r = 0.339, p < 0.0001). According to Cox regression analysis of the prediction power of sE-selectin for all-cause mortality, high sE-selectin levels independently and significantly predicted short-term mortality in CHF (HR 1.47, 95% CI 1.103–1.956). Furthermore, sE-selectin predicted mortality in CHF patients with concomitant diabetes mellitus, as well as simultaneously elevated sE-selectin and NT-proBNP levels additively predicted mortality.

Conclusions

This study demonstrated a weak correlation of sE-selectin level with inflammatory markers and prediction of short-term mortality in diabetic CHF patients. Elevated serum sE-selectin levels and concomitantly increased NT-proBNP concentrations have additive predictive power in CHF. This suggests that parallel activation of various pathophysiological pathways confers increased risk of adverse outcome in CHF.

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Acknowledgments

We are grateful to our patients who consented to participate in this study. The authors appreciate the skillful technical assistance of Holeczky Rudolfné, Szigeti Antalné, Korponai Gézáné, Sturmann Piroska and Kókai Márta. This study was supported by the following grants: Hungarian Scientific Research Fund (OTKA T046837, NF72689, ZP), and National Development Agency TÁMOP 4.2.2-08/01/KMR-2008-0004 (Semmelweis Bridge Project).

Conflict of interest

No financial conflicts of interest are present with regard to this manuscript by the authors.

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Authors and Affiliations

  1. Research Laboratory, 3rd Department of Internal Medicine, Szentágothai Knowledge Center, Semmelweis University, Budapest, Hungary

    Judit Czúcz, Zsolt Förhécz, Tímea Gombos, Zoltán Pozsonyi, István Karádi, Lívia Jánoskuti & Zoltán Prohászka

  2. Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary

    László Cervenak & Zoltán Prohászka

  3. Department of Global Medical Affairs, BRAHMS GmbH, Neuendorf Str. 25, 16761, Hennigsdorf, Germany

    Jan Kunde

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  1. Judit Czúcz
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  2. László Cervenak
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  3. Zsolt Förhécz
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  5. Zoltán Pozsonyi
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  6. Jan Kunde
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  8. Lívia Jánoskuti
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  9. Zoltán Prohászka
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Correspondence to Judit Czúcz.

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Czúcz, J., Cervenak, L., Förhécz, Z. et al. Serum soluble E-selectin and NT-proBNP levels additively predict mortality in diabetic patients with chronic heart failure. Clin Res Cardiol 100, 587–594 (2011). https://doi.org/10.1007/s00392-011-0283-6

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  • DOI: https://doi.org/10.1007/s00392-011-0283-6

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