Predictive Value of Endostatin in Chronic Heart Failure Patients with Poor Kidney Function

• Published in: Cardiology Vol. 130; no. 1; pp. 17 - 22
• Main Authors: Ueland, Thor, Aukrust, Pål, Nymo, Ståle H., Kjekshus, John, McMurray, John J.V., Wikstrand, John, Wienhues-Thelen, Ursula-Henrike, Block, Dirk, Zaugg, Christian, Gullestad, Lars
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2015
• Subjects: Aged; Aged, 80 and over; C-Reactive Protein - metabolism; Cardiology; Endostatins - blood; Female; Fluorobenzenes - therapeutic use; Glomerular Filtration Rate - physiology; Heart failure; Heart Failure, Systolic - blood; Heart Failure, Systolic - drug therapy; Heart Failure, Systolic - mortality; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Immunoenzyme Techniques; Kidney Diseases - blood; Kidney Diseases - drug therapy; Kidney Diseases - mortality; Kidneys; Male; Medical prognosis; Middle Aged; Natriuretic Peptide, Brain - blood; Original Research; Pyrimidines - therapeutic use; Rosuvastatin Calcium; Statins; Sulfonamides - therapeutic use; Heart failure; Prognosis; Kidney function; Survival; Endostatin
• ISSN: 0008-6312; 1421-9751
• DOI: 10.1159/000368220

Objectives: Increased circulating endostatin levels have been demonstrated in progressive cardiovascular (CV) and renal disorders. We investigated the predictive value of endostatin in patients with chronic heart failure (HF) and the association between endostatin and renal function. Methods: The interaction between serum endostatin, estimated glomerular filtration rate (eGFR) and predefined endpoints, including the primary endpoint (CV death, nonfatal myocardial infarction, nonfatal stroke; n = 397), all-cause mortality (n = 410), CV death (n = 335) or the coronary endpoint (n = 317), was evaluated in 1,390 patients >60 years of age with ischemic systolic HF in the Controlled Rosuvastatin Multinational Trial in HF (CORONA) population, who were randomly assigned to 10 mg rosuvastatin or placebo. Results: In the population as a whole, endostatin added no predictive information after full multivariable adjustment including eGFR and N-terminal pro-brain natriuretic peptide. Serum endostatin was strongly correlated with eGFR (r = 0.59, p < 0.001). After full multivariable adjustment, an association between high serum endostatin and increased risk of all-cause mortality and decreased risk of the primary and coronary endpoints was seen in HF patients with impaired and preserved renal function, respectively. Conclusions: Endostatin added no predictive information regarding the adverse outcome in patients with chronic systolic HF of ischemic etiology. An increased risk of all-cause mortality was seen in patients with decreased renal function. i 2014 S. Karger AG, Basel