Jiandi Wu1, Haoxiao Zheng2, Xinyue Liu2, Peisong Chen3, Yunlong Zhang4, Jianjin Luo2,5, Jian Kuang6,7, Jingwei Li8, Yu Yang9, Tianyi Ma10, Yanhua Yang11, Xiaohui Huang2, Guoquan Liang5, Donglian Liang1, Yunzhao Hu2, Jason H Y Wu12, Clare Arnott12,13,14, Weiyi Mai6,7, Yuli Huang2,12. 1. Department of Cardiology, Affiliated Foshan Hospital (J.W., D.L.), Southern Medical University, Foshan, China. 2. Department of Cardiology, Shunde Hospital (H.Z., X.L., J. Luo, X.H., Y. Hu, Y. Huang), Southern Medical University, Foshan, China. 3. Department of Laboratory medicine (P.C.), the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 4. Key Laboratory of Neuroscience, School of Basic Medical Sciences, Guangzhou Medical University, China (Y.Z.). 5. Department of Cardiology, the Second Hospital of Zhaoqing, Guangdong, China (J. Luo, G.L.). 6. Department of Cardiology (J.K., W.M.), the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 7. NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), China (J.K., W.M.). 8. Department of Cardiology, People's Liberation Army General Hospital, Beijing, China (J. Li). 9. Department of Geriatrics, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China (Yu Yang). 10. Department of Cardiology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Changsha, China (T.M.). 11. Department of Cardiology, Dongguan people's Hospital (Yanhua Yang), Southern Medical University, Foshan, China. 12. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (J.H.Y.W., C.A., Y. Huang). 13. Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia (C.A.). 14. Charles Perkins Centre, University of Sydney, NSW, Australia (C.A.).
Abstract
BACKGROUND: Patients with heart failure (HF) with diabetes mellitus have distinct biomarker profiles compared with those without diabetes mellitus. SFRP5 (secreted frizzled-related protein 5) is an anti-inflammatory adipokine with an important suppressing role on the development of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the prognostic value of SFRP5 in patients with HF with and without T2DM. METHODS: The study included 833 consecutive patients with HF, 312 (37.5%) of whom had T2DM. Blood samples were collected at presentation, and SFRP5 levels were measured. The primary outcome was the composite end points of first occurrence of HF rehospitalization or all-cause mortality during follow-up. RESULTS: During median follow-up of 2.1 years, 335 (40.2%) patients in the cohort experienced the composite primary outcome. After adjustment for multiple risk factors, each doubling of SFRP5 level was associated with a 21% decreased risk of primary outcomes in the overall study population (P<0.001). Subgroup analyses showed that the association between level of SFPR5 and primary outcomes may be stronger in patients with T2DM (hazard ratio, 0.69 [95% CI, 0.61-0.79]) than in patients without T2DM (hazard ratio, 0.89 [95% CI, 0.79-1.01]; interaction P=0.006). Similar associations were observed when taking SFRP5 as a categorical variable. Addition of SFRP5 significantly improved discrimination and reclassification of the incident primary outcomes beyond clinical risk factors and N-terminal pro-B-type natriuretic peptide in all patients with HF and those with T2DM (all P<0.01). CONCLUSIONS: SFRP5 is an independent novel biomarker for risk stratification in HF, especially in HF with T2DM.
BACKGROUND:Patients with heart failure (HF) with diabetes mellitus have distinct biomarker profiles compared with those without diabetes mellitus. SFRP5 (secreted frizzled-related protein 5) is an anti-inflammatory adipokine with an important suppressing role on the development of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the prognostic value of SFRP5 in patients with HF with and without T2DM. METHODS: The study included 833 consecutive patients with HF, 312 (37.5%) of whom had T2DM. Blood samples were collected at presentation, and SFRP5 levels were measured. The primary outcome was the composite end points of first occurrence of HF rehospitalization or all-cause mortality during follow-up. RESULTS: During median follow-up of 2.1 years, 335 (40.2%) patients in the cohort experienced the composite primary outcome. After adjustment for multiple risk factors, each doubling of SFRP5 level was associated with a 21% decreased risk of primary outcomes in the overall study population (P<0.001). Subgroup analyses showed that the association between level of SFPR5 and primary outcomes may be stronger in patients with T2DM (hazard ratio, 0.69 [95% CI, 0.61-0.79]) than in patients without T2DM (hazard ratio, 0.89 [95% CI, 0.79-1.01]; interaction P=0.006). Similar associations were observed when taking SFRP5 as a categorical variable. Addition of SFRP5 significantly improved discrimination and reclassification of the incident primary outcomes beyond clinical risk factors and N-terminal pro-B-type natriuretic peptide in all patients with HF and those with T2DM (all P<0.01). CONCLUSIONS:SFRP5 is an independent novel biomarker for risk stratification in HF, especially in HF with T2DM.
Authors: Nga Phi Thi Nguyen; Thuc Luong Cong; Binh Thanh Vu; Tuan Dinh Le; Thi Thanh Hoa Tran; Binh Nhu Do; Son Tien Nguyen; Lan Ho Thi Nguyen; Manh Van Ngo; Hoa Trung Dinh; Hoang Duong Huy; Nghia Xuan Vu; Kien Nguyen Trung; Duong Ngoc Vu; Nghia The Pham Journal: Int J Gen Med Date: 2022-03-08