© 2007 European Society of Cardiology
Plasma level of cardiotrophin-1 as a prognostic predictor in patients with chronic heart failure
a Department of Cardiovascular Medicine, Shiga University of Medical Science Seta-Tsukinowa, Otsu, 520-2192, Japan
b Diagnostic Department, Shionogi & Co., Ltd. 2-5-1 Mishima, Settsu-shi, Osaka 566-0022, Japan
c Kusatsu General Hospital Kusatsu, 520-0028, Japan
d First Department of Internal Medicine, Nara Medical University Kashihara, Nara, 634-8522, Japan
* Corresponding author. Tel.: +81 775 48 2215; fax: +81 775 43 5839. E-mail address: tutamoto{at}belle.shiga-med.ac.jp (T. Tstamoto).
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Abstract |
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Background: Cardiotrophin-1 (CT-1) is a member of the interleukin (IL-6) family of cytokines and is increased in patients with chronic heart failure (CHF).
Aims: To evaluate the prognostic role of CT-1 in patients with CHF.
Methods and results: We measured the plasma levels of CT-1, brain natriuretic peptide (BNP), and IL-6 in 125 patients with CHF. Patients were monitored for a mean follow-up period of 2.9years. Plasma levels of CT-1 increased with severity of CHF. There was a significant negative correlation between plasma CT-1 and left ventricular ejection fraction. There was a significant correlation between plasma CT-1 and log IL-6. During the follow-up period, 37 patients died. High plasma levels of CT-1, BNP, and IL-6 were independent predictors of mortality on stepwise multivariate analysis. The hazard ratio for mortality in patients with plasma BNP>170pg/mL and CT-1>658fmol/mL was 2.48 (95% confidence interval, 1.217–5.060) compared to those with plasma BNP>170pg/mL and CT-1<658fmol/mL (p=0.0124).
Conclusion: These findings indicate that plasma CT-1 measurement provides additional prognostic information and that combined levels of CT-1 and BNP are more accurate at predicting mortality in patients with CHF than either marker alone.
Key Words: Cardiotrophin-1 • Brain natriuretic peptide • Heart failure • Prognosis • Interleukin 6
Received March 26, 2007; Revised June 13, 2007; Accepted July 23, 2007
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