Association of plasma thioredoxin-1 with renal tubular damage and cardiac prognosis in patients with chronic heart failure

• Published in: Journal of cardiology Vol. 64; no. 5; pp. 353 - 359
• Main Authors: Otaki, Yoichiro, MD, Watanabe, Tetsu, MD, PhD, FJCC, Takahashi, Hiroki, MD, PhD, Kadowaki, Shinpei, MD, Narumi, Taro, MD, Honda, Yuki, MD, Wanezaki, Masahiro, MD, Sasaki, Shintaro, MD, PhD, Tamura, Harutoshi, MD, PhD, Nishiyama, Satoshi, MD, PhD, Arimoto, Takanori, MD, PhD, Shishido, Tetsuro, MD, PhD, Miyamoto, Takuya, MD, PhD, Kubota, Isao, MD, PhD, FJCC
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.11.2014
• Subjects: Aged; Biomarkers - blood; Cardiovascular; Chronic Disease; Comorbidity; Female; Follow-Up Studies; Heart failure; Heart Failure - diagnosis; Heart Failure - epidemiology; Humans; Kidney Diseases - diagnosis; Kidney Diseases - epidemiology; Kidney function; Kidney Tubules; Male; Middle Aged; Oxidative Stress; Predictive Value of Tests; Prognosis; Risk; Thioredoxin-1; Thioredoxins - blood; Thioredoxins - physiology; Time Factors; Heart failure; Thioredoxin-1; Kidney function
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2014.02.016

Abstract Background Thioredoxin-1 (Trx-1) is an abundant 12.5 kDa redox protein expressed in almost all eukaryotic cells that protect against the development of heart failure and kidney dysfunction. Plasma Trx-1 levels are considered as a reliable marker for oxidative stress. However, it remains to be determined whether plasma Trx-1 levels can predict cardiac prognosis in patients with chronic heart failure (CHF). Methods and results We measured plasma Trx-1 levels and urinary β2 -microglobulin–creatinine ratio (UBCR), a marker for renal tubular damage, in 156 consecutive patients with CHF and 17 control subjects. The patients were prospectively followed for a median follow-up period of 627 days and 46 cardiac events were observed. The patients with cardiac events had significantly higher plasma Trx-1 levels and UBCR levels than the cardiac event-free patients. Multivariate Cox proportional hazard analysis revealed that an elevated Trx-1 level was independently associated with poor outcome in patients with CHF after adjustment for confounding factors (hazard ratio, 1.74; 95% confidence interval, 1.33–2.29; p < 0.0001). UBCR was increased with higher plasma Trx-1 levels. Kaplan–Meier analysis demonstrated that the highest Trx-1 tertile was associated with the highest risk of cardiac events. Conclusion Plasma Trx-1 level was associated with renal tubular damage and cardiac prognosis, suggesting that it could be a useful marker to identify patients at high risk for comorbid heart failure and renal tubular damage.