Antoni Bayés-Genís1, Jaume Barallat2, Domingo Pascual-Figal3, Domingo Pascual3, Julio Nuñez4, Gema Miñana5, Jesús Sánchez-Mas3, Amparo Galan2, Juan Sanchis6, Elisabet Zamora7, María Teresa Pérez-Martínez3, Josep Lupón7. 1. Cardiology Service and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain. Electronic address: abayesgenis@gmail.com. 2. Biochemistry Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. 3. Cardiology Department, Hospital Virgen de la Arrixaca, Department of Medicine, University of Murcia, Murcia, Spain. 4. Biochemistry Service, Hospital Clínico Universitario, Valencia, Spain; University of Valencia, Valencia, Spain. 5. Cardiology Service, Hospital Clínico Universitario, Valencia, Spain. 6. University of Valencia, Valencia, Spain; Cardiology Service, Hospital de Manises, Valencia, Spain. 7. Cardiology Service and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
Abstract
OBJECTIVES: This study sought to examine the prognostic value of the soluble form of neprilysin (sNEP) in acute heart failure (AHF) and sNEP kinetics during hospital admission. BACKGROUND: sNEP was recently identified in chronic heart failure (HF) and was associated with cardiovascular outcomes. METHODS: A total of 350 patients (53% women, mean 72.6 ± 10.7 years of age) were included in the study. Primary endpoints were composites of cardiovascular death or HF hospitalizations at short-term (2 months) and long-term (mean: 1.8 ± 1.2 years) follow-up. sNEP was measured using an ad hoc-modified enzyme-linked immunosorbent assay, and its prognostic value was assessed using Cox regression analyses. In a subgroup of patients, sNEP was measured both at admission and at discharge (n = 92). RESULTS: Median admission sNEP concentrations were 0.67 ng/ml (Q1 to Q3: 0.37 to 1.29), and sNEP was significantly associated, in age-adjusted Cox regression analyses, with the composite endpoint at short-term (hazard ratio [HR]: 1.29; 95% confidence interval [CI]: 1.04 to 1.61; p = 0.02) and long-term (HR: 1.23; 95% CI: 1.01 to 1.05; p = 0.003) follow-up. In multivariate Cox analyses that included clinical variables and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration, sNEP concentration at admission showed a clear trend toward significance for the composite endpoint at 2 months (HR: 1.22; 95% CI: 0.97 to 1.53; p = 0.09) and remained significant at the end of follow-up (HR: 1.21; 95% CI: 1.04 to 1.40; p = 0.01). At discharge, sNEP levels decreased from 0.70 to 0.52 ng/ml (p = 0.06). CONCLUSIONS: Admission sNEP concentration was associated with short- and long-term outcomes in AHF, and dynamic sNEP concentrations were observed during hospital admission. These preliminary data may be hypothesis-generating for the use of NEP inhibitors in AHF.
OBJECTIVES: This study sought to examine the prognostic value of the soluble form of neprilysin (sNEP) in acute heart failure (AHF) and sNEP kinetics during hospital admission. BACKGROUND:sNEP was recently identified in chronic heart failure (HF) and was associated with cardiovascular outcomes. METHODS: A total of 350 patients (53% women, mean 72.6 ± 10.7 years of age) were included in the study. Primary endpoints were composites of cardiovascular death or HF hospitalizations at short-term (2 months) and long-term (mean: 1.8 ± 1.2 years) follow-up. sNEP was measured using an ad hoc-modified enzyme-linked immunosorbent assay, and its prognostic value was assessed using Cox regression analyses. In a subgroup of patients, sNEP was measured both at admission and at discharge (n = 92). RESULTS: Median admission sNEP concentrations were 0.67 ng/ml (Q1 to Q3: 0.37 to 1.29), and sNEP was significantly associated, in age-adjusted Cox regression analyses, with the composite endpoint at short-term (hazard ratio [HR]: 1.29; 95% confidence interval [CI]: 1.04 to 1.61; p = 0.02) and long-term (HR: 1.23; 95% CI: 1.01 to 1.05; p = 0.003) follow-up. In multivariate Cox analyses that included clinical variables and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration, sNEP concentration at admission showed a clear trend toward significance for the composite endpoint at 2 months (HR: 1.22; 95% CI: 0.97 to 1.53; p = 0.09) and remained significant at the end of follow-up (HR: 1.21; 95% CI: 1.04 to 1.40; p = 0.01). At discharge, sNEP levels decreased from 0.70 to 0.52 ng/ml (p = 0.06). CONCLUSIONS: Admission sNEP concentration was associated with short- and long-term outcomes in AHF, and dynamic sNEP concentrations were observed during hospital admission. These preliminary data may be hypothesis-generating for the use of NEP inhibitors in AHF.
Authors: Denise Traxler; Andreas Spannbauer; Patrick Einzinger; Julia Mester-Tonczar; Dominika Lukovic; Johannes Winkler; Katrin Zlabinger; Alfred Gugerell; LJubica Mandic; Mariann Gyöngyösi; Noemi Pavo Journal: Int J Mol Sci Date: 2020-06-28 Impact factor: 5.923
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Authors: Yogesh N V Reddy; Seethalakshmi R Iyer; Christopher G Scott; Richard J Rodeheffer; Kent Bailey; Gregory Jenkins; Anthony Batzler; Margaret M Redfield; John C Burnett; Naveen L Pereira Journal: J Am Heart Assoc Date: 2019-07-26 Impact factor: 5.501
Authors: Elena Revuelta-López; Julio Núñez; Paloma Gastelurrutia; Germán Cediel; James L Januzzi; Nasrien E Ibrahim; Michele Emdin; Roland VanKimmenade; Domingo Pascual-Figal; Eduardo Núñez; Frank Gommans; Josep Lupón; Antoni Bayés-Genís Journal: ESC Heart Fail Date: 2020-02-11