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Cardiotrophin-1 predicts death or heart failure following acute myocardial infarction

By Sohail Q. Khan, Dominic Kelly, Paulene Quinn, Joan E. Davies and Leong L. Ng

Abstract

This is the authors' final draft of the paper published as Journal of Cardiac Failure, 2006, 12(8), pp.635-640. The final published version is available on www.sciencedirect.com, doi: 10.1016/j.cardfail.2006.06.470.Background: Cardiotrophin-1 (CT-1) is an important inflammatory cytokine, its presence has been documented in patients following acute myocardial infarction (AMI). However its role as a predictor of death or heart failure is unclear. We sought to investigate this and compared it to N terminal pro B type natriuretic peptide (NT-proBNP), a marker of death or heart failure Methods: We studied 291 post AMI patients. The plasma concentration of CT-1 and NT-proBNP was determined using in-house non-competitive immunoassays and patients followed-up for death or heart failure Results: There were 27 deaths and 19 readmissions with heart failure. CT-1 was raised in patients with death or heart failure compared to survivors (median [range] fmol/ml, 0.9[0.1-392.2] vs. 0.67[0-453.3], p=0.019). Using a multivariate binary logistic model CT-1 (OR 1.8, 95% CI: 1.1-3.2, p=0.031) and NT-proBNP (OR 2.4, 95% CI: 1.1-5.2, p=0.026) predicted death or heart failure independently of age, sex, previous AMI, serum creatinine and Killip class. The receiver-operating curve for CT-1 yielded an area under the curve (AUC) of 0.62 (95% CI: 0.53-0.70, p=0.017) for NT-proBNP the AUC was 0.77 (95% CI: 0.69-0.86, p<0.001); the logistic model combining the 2 markers yielded an AUC of 0.84 (95% CI: 0.78-0.91, p<0.001). Conclusion: After an AMI, combined levels of CT-1 and NT-proBNP are more informative at predicting death or heart failure than either marker alone

Publisher: Elsevier
Year: 2006
DOI identifier: 10.1016/j.cardfail.2006.06.470.
OAI identifier: oai:lra.le.ac.uk:2381/3293

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Citations

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