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Serum cholinesterase is an important prognostic factor in chronic heart failure

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Abstract

We determine the importance of indicators of nutrition including lymphocyte, total protein, albumin, cholinesterase and body mass index, and compare the prognostic significance in chronic heart failure (CHF). We examined consecutive 465 CHF patients (376 males, age 62 ± 14 years) who underwent cardiopulmonary exercise testing, echocardiography and blood examination including indicators of nutrition at the same time in our hospital. The patients were followed up [median period 766 days (interquartile range 500–1060)] to register cardiac deaths and rehospitalization due to worsening heart failure. There were 180 cardiac events during the follow-up periods. Patients with cardiac events had lower cholinesterase level than those without events (P < 0.001). On the receiver operating characteristic analysis, the best cut-off value for cholinesterase was 240 U/l (area under the curve 0.720). In the Kaplan–Meier analysis, patients with cholinesterase <240 U/l had significantly higher cardiac event rates than those with cholinesterase >240 U/l. Multivariable Cox proportional hazards model demonstrated that NYHA class III [hazard ratio (HR): 1.688, 95 % confidence interval (CI) 1.062–2.684, P = 0.027], eGFR (HR: 0.983, 95 % CI 0.971–0.995, P = 0.006), sodium concentration (HR: 0.947, 95 % CI 0.897–0.999, P < 0.046), log BNP (HR: 1.880, 95 % CI 1.509–2.341, P < 0.001), cholinesterase (HR: 0.996, 95 % CI 0.993–0.998, P = 0.002) and exertional periodic breathing (HR: 1.619, 95 % CI 1.098–2.388, P = 0.015) were independent factors to predict adverse clinical outcomes. Serum cholinesterase level was an important prognostic factor in CHF.

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Acknowledgments

We received helpful advice for statistical analyses from Dr. Tetsuya Ohira in Department of Epidemiology and Dr. Hajime Iwasa in Department of Public Health, Fukushima Medical University. This study was supported in part by Grants-In-Aid for Scientific Research (Nos. 23700613 and 247591100) from the Japan Society for the Promotion of Science and grants-in-aid from the Japanese Ministry of Health, Labor and Welfare, Tokyo, Japan.

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  1. Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Takamasa Sato, Hiroyuki Yamauchi, Satoshi Suzuki, Akiomi Yoshihisa, Takayoshi Yamaki, Koichi Sugimoto, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-ichi Saitoh & Yasuchika Takeishi

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  1. Takamasa Sato
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  2. Hiroyuki Yamauchi
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  3. Satoshi Suzuki
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  4. Akiomi Yoshihisa
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  5. Takayoshi Yamaki
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Correspondence to Takamasa Sato.

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Sato, T., Yamauchi, H., Suzuki, S. et al. Serum cholinesterase is an important prognostic factor in chronic heart failure. Heart Vessels 30, 204–210 (2015). https://doi.org/10.1007/s00380-014-0469-8

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