Relation of Peripheral Collagen Markers to Death and Hospitalization in Patients With Heart Failure and Preserved Ejection Fraction Results of the I-PRESERVE Collagen Substudy
Relation of Peripheral Collagen Markers to Death and Hospitalization in Patients With Heart Failure and Preserved Ejection Fraction Results of the I-PRESERVE Collagen Substudy
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DOI：
10.1161/circheartfailure.110.960716
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发表时间：
2011-09-01
影响因子：
9.7
通讯作者：
Anand, Inder S.
中科院分区：
文献类型：
--
作者：
Krum, Henry;Elsik, Maros;Anand, Inder S.
背景-心力衰竭伴保留射血分数(HFPEF)是一个常见且日益严重的公共健康问题。心肌纤维化是HFPEF的重要病理特征。外周胶原标记物可能反映了这种过度的纤维化；然而，这些标记物与HFPEF患者预后的关系尚未确定。方法和结果-这项关于厄贝沙坦治疗收缩功能保留的心力衰竭(I-PREVERE)试验的子研究测定了334名HFPEF患者血浆I型前胶原氨基端肽、III型前胶原氨基端肽和骨桥蛋白的水平。测量在基线和随机服用安慰剂或厄贝沙坦300 mg/d后6个月进行。通过单变量和多变量分析评估基线胶原标记物与I保存主要终点(全因死亡和因预先确定的心血管原因住院)的关系。仅对全因死亡和心力衰竭事件(因心力衰竭死亡或住院)进行了类似的评估。基线时血浆胶原标记物水平的升高与所有胶原标记物的主要终点出现频率的增加有关。前胶原蛋白I型氨基端肽每增加10微克/L，主要终点的危险比(HR)为1.0 9(95%CI，1.052比1.13；P
Background-Heart failure with preserved ejection fraction (HFPEF) is a common and increasing public health problem. Myocardial fibrosis is a key pathological feature of HFPEF. Peripheral collagen markers may reflect this excess fibrosis; however, the relation of these markers to prognosis in patients with HFPEF has not as yet been determined.Methods and Results-This substudy of the Irbesartan in Heart Failure With Preserved Systolic Function (I-PRESERVE) trial measured plasma levels of procollagen type I amino-terminal peptide, procollagen type III amino-terminal peptide, and osteopontin in 334 patients with HFPEF. Measurements were performed at baseline and 6 months after randomization to placebo or irbesartan 300 mg/day. The relation of baseline collagen markers to the I-PRESERVE primary end point (all-cause death and hospitalization for prespecified cardiovascular causes) was evaluated by single and multivariable analysis. Similar evaluations were performed for all-cause death alone as well as heart failure events (death or hospitalization because of heart failure). Increased plasma levels of collagen markers at baseline were associated with increased frequency of the study primary end point for all collagen markers. For each 10-mu g/L increase in procollagen type I amino-terminal peptide, the hazard ratio (HR) for the primary end point was 1.09 (95% CI, 1.052 to 1.13; P