Urinary 8-hydroxy-2'-deoxyguanosine as a novel biomarker for predicting cardiac events and evaluating the effectiveness of carvedilol treatment in patients with chronic systolic heart failure.
Urinary 8-hydroxy-2'-deoxyguanosine as a novel biomarker for predicting cardiac events and evaluating the effectiveness of carvedilol treatment in patients with chronic systolic heart failure.
复制标题
DOI：
10.1253/circj.cj-11-0537
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Takehisa Susa;Shigeki Kobayashi;Takeo Tanaka;Wakako Murakami;Shintaro Akashi;I. Kunitsugu;S. Okuda;M. Doi;Y. Wada;T. Nao;Jutaro Yamada;T. Ueyama;T. Okamura;M. Yano;M. Matsuzaki
中科院分区：
文献类型：
--
作者：
Takehisa Susa;Shigeki Kobayashi;Takeo Tanaka;Wakako Murakami;Shintaro Akashi;I. Kunitsugu;S. Okuda;M. Doi;Y. Wada;T. Nao;Jutaro Yamada;T. Ueyama;T. Okamura;M. Yano;M. Matsuzaki
背景 作者最近报道，源自心脏组织的尿液 8-羟基-2'-脱氧鸟苷 (U8-OHdG) 反映了慢性心力衰竭 (CHF) 患者的临床状态和心功能不全的严重程度。本研究的目的是调查 U8-OHdG 水平是否可以准确预测 CHF 患者的心脏事件及其对 β 受体阻滞剂治疗的反应。方法和结果 在出院前连续测量 186 名 CHF 患者的血浆脑钠肽 (BNP) 和 U8-OHdG 水平。然后对患者进行前瞻性随访（中位随访 649 天），终点为心源性死亡或因进行性心力衰竭而住院。根据受试者工作特征曲线分析，U8-OHdG 的截止值为 12.4ng/mg 肌酐 (Cr)，BNP 的截止值为 207pg/ml。在多变量 Cox 分析中，U8-OHdG 和 BNP 是心脏事件的独立预测因子。根据 U8-OHdG 和 BNP 截止值将患者分为 4 组。 BNP ≥207pg/ml 和 U8-OHdG ≥12.4ng/mg Cr 的患者发生心脏事件的风险比为 16.2，而仅 1 项指标高于其各自截止值的患者的心脏事件风险比约为 4。此外，30 名 CHF 患者开始使用卡维地洛治疗。在缓解者中（左心室射血分数 [LVEF] 增加 ≥10% 或纽约心脏协会 [NYHA] 等级降低 ≥1 级），治疗后 U8-OHdG 水平显着下降，同时 NYHA 等级、LVEF 和 BNP 水平改善。结论 U8-OHdG 可能是预测 CHF 患者心脏事件和评估 β 受体阻滞剂治疗效果的有用生物标志物。
BACKGROUND The authors recently reported that urinary 8-hydroxy-2'-deoxyguanosine (U8-OHdG) derived from cardiac tissue reflects clinical status and cardiac dysfunction severity in patients with chronic heart failure (CHF). The aim of the present study was to investigate whether U8-OHdG levels can accurately predict cardiac events in CHF patients and their response to β-blocker treatment. METHODS AND RESULTS Plasma brain natriuretic peptide (BNP) and U8-OHdG levels were measured in 186 consecutive CHF patients before discharge. Patients were then prospectively followed (median follow-up, 649 days) with endpoints of cardiac death or hospitalization due to progressive heart failure. From receiver operating characteristic curve analysis, cut-offs were 12.4ng/mg creatinine (Cr) for U8-OHdG and 207pg/ml for BNP. On multivariate Cox analysis, U8-OHdG and BNP were independent predictors of cardiac events. Patients were classified into 4 groups according to U8-OHdG and BNP cut-offs. The hazard ratio for cardiac events in patients with BNP ≥207pg/ml and U8-OHdG ≥12.4ng/mg Cr was 16.2 compared with approximately 4 for patients with only 1 indicator above its respective cut-off. Furthermore, carvedilol therapy was initiated in 30 CHF patients. In responders (≥10% increase in left ventricular ejection fraction [LVEF] or ≥1 class decrease in New York Heart Association [NYHA] class), U8-OHdG levels decreased significantly along with improved NYHA class, LVEF, and BNP levels after treatment. CONCLUSIONS U8-OHdG may be a useful biomarker for predicting cardiac events and evaluating β-blocker therapy effectiveness in CHF patients.