Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome
Background: Internal cardioverter defibrillator (ICD) therapy reduced all-cause mortality. Conversely, few studies reported that ICDs' shocks may reduce survival. Recently authors suggested that, multiple inflammatory and molecular pathways were related to worse prognosis in metabolic syndrome...
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| Format: | Article |
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Frontiers Media S.A.
2018-06-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2018.00758/full |
| _version_ | 1818412850936283136 |
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| author | Celestino Sardu Raffaele Marfella Matteo Santamaria Stefano Papini Quintino Parisi Cosimo Sacra Daniele Colaprete Giuseppe Paolisso Maria R. Rizzo Michelangela Barbieri |
| author_facet | Celestino Sardu Raffaele Marfella Matteo Santamaria Stefano Papini Quintino Parisi Cosimo Sacra Daniele Colaprete Giuseppe Paolisso Maria R. Rizzo Michelangela Barbieri |
| author_sort | Celestino Sardu |
| collection | DOAJ |
| description | Background: Internal cardioverter defibrillator (ICD) therapy reduced all-cause mortality. Conversely, few studies reported that ICDs' shocks may reduce survival. Recently authors suggested that, multiple inflammatory and molecular pathways were related to worse prognosis in metabolic syndrome (MS) patients treated by ICDs. Therefore, it may be relevant to find new biomarkers to predict ICDs' shock and worse prognosis in treated patients.Methods: In 99 MS vs. 107 no MS patients treated by ICD for primary prevention, we evaluated all-cause mortality, cardiac deaths, hospitalization for heart failure, appropriate and inappropriate therapy, and survival after appropriate ICD therapy.Results: MS vs. no MS patients had higher levels of failing heart stress biomarkers. The highest values of ST2 were related to worse prognosis. Patients who had better survival after appropriate ICD therapy were those associated with lowest ST2 values. At multivariate Cox regression analysis, C reactive protein (CRP) (0.110 [0.027–0.446], p-value 0.002), troponine I (TnI) protein (0.010 [0.001–0.051], p-value 0.010), and B type natriuretic peptide (BNP) (1.151 [1.010–1.510], p-value 0.001), predicted all cause of deaths. BNP predicted cardiac deaths (1.010 [1.001–1.206], p-value 0.033). MS, and BNP predicted hospitalization for heart failure events (2.902 [1.345–4.795], p-value 0.001; 1.005 [1.000–1.016], p-value 0.007). ST2 predicted appropriate therapy (1.012 [1.007–1.260], p-value 0.001), as BNP (1.005 [1.001–1.160], p-value 0.028), LVEF (1.902 [1.857–1.950], p-value 0.001), and CRP (1.833 [1.878–1.993], p-value 0.028). ST2, and BNP predicted survival after ICD appropriate therapy (4.297 [1.985–9.302], p-value 0.001; 1.210 [1.072–1.685], p-value 0.024).Conclusions: ST2 values may differentiate MS patients with a higher risk of ICDs' therapy, and worse prognosis. Therefore, ST2 protein may be used as valid monitoring biomarker, and as a predictive biomarker in failing heart ICDs' patients affected by MS. |
| first_indexed | 2024-12-14T10:53:52Z |
| format | Article |
| id | doaj.art-54a257a5ab3b4affb1c64738ead40515 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-14T10:53:52Z |
| publishDate | 2018-06-01 |
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| series | Frontiers in Physiology |
| spelling | doaj.art-54a257a5ab3b4affb1c64738ead405152022-12-21T23:05:02ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2018-06-01910.3389/fphys.2018.00758363690Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic SyndromeCelestino Sardu0Raffaele Marfella1Matteo Santamaria2Stefano Papini3Quintino Parisi4Cosimo Sacra5Daniele Colaprete6Giuseppe Paolisso7Maria R. Rizzo8Michelangela Barbieri9Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Naples, ItalyDepartment of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Naples, ItalyDepartment of Cardiovascular and Arrhythmias, John Paul II Research and Care Foundation, Campobasso, ItalyDepartment of Cardiovascular and Arrhythmias, John Paul II Research and Care Foundation, Campobasso, ItalyDepartment of Cardiovascular and Arrhythmias, John Paul II Research and Care Foundation, Campobasso, ItalyDepartment of Cardiovascular and Arrhythmias, John Paul II Research and Care Foundation, Campobasso, ItalyDepartment of Cardiovascular and Arrhythmias, John Paul II Research and Care Foundation, Campobasso, ItalyDepartment of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Naples, ItalyDepartment of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Naples, ItalyDepartment of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Naples, ItalyBackground: Internal cardioverter defibrillator (ICD) therapy reduced all-cause mortality. Conversely, few studies reported that ICDs' shocks may reduce survival. Recently authors suggested that, multiple inflammatory and molecular pathways were related to worse prognosis in metabolic syndrome (MS) patients treated by ICDs. Therefore, it may be relevant to find new biomarkers to predict ICDs' shock and worse prognosis in treated patients.Methods: In 99 MS vs. 107 no MS patients treated by ICD for primary prevention, we evaluated all-cause mortality, cardiac deaths, hospitalization for heart failure, appropriate and inappropriate therapy, and survival after appropriate ICD therapy.Results: MS vs. no MS patients had higher levels of failing heart stress biomarkers. The highest values of ST2 were related to worse prognosis. Patients who had better survival after appropriate ICD therapy were those associated with lowest ST2 values. At multivariate Cox regression analysis, C reactive protein (CRP) (0.110 [0.027–0.446], p-value 0.002), troponine I (TnI) protein (0.010 [0.001–0.051], p-value 0.010), and B type natriuretic peptide (BNP) (1.151 [1.010–1.510], p-value 0.001), predicted all cause of deaths. BNP predicted cardiac deaths (1.010 [1.001–1.206], p-value 0.033). MS, and BNP predicted hospitalization for heart failure events (2.902 [1.345–4.795], p-value 0.001; 1.005 [1.000–1.016], p-value 0.007). ST2 predicted appropriate therapy (1.012 [1.007–1.260], p-value 0.001), as BNP (1.005 [1.001–1.160], p-value 0.028), LVEF (1.902 [1.857–1.950], p-value 0.001), and CRP (1.833 [1.878–1.993], p-value 0.028). ST2, and BNP predicted survival after ICD appropriate therapy (4.297 [1.985–9.302], p-value 0.001; 1.210 [1.072–1.685], p-value 0.024).Conclusions: ST2 values may differentiate MS patients with a higher risk of ICDs' therapy, and worse prognosis. Therefore, ST2 protein may be used as valid monitoring biomarker, and as a predictive biomarker in failing heart ICDs' patients affected by MS.https://www.frontiersin.org/article/10.3389/fphys.2018.00758/fullST2 proteinheart failureinternal cardioverter defibrillatorICDs' shockshospitalization |
| spellingShingle | Celestino Sardu Raffaele Marfella Matteo Santamaria Stefano Papini Quintino Parisi Cosimo Sacra Daniele Colaprete Giuseppe Paolisso Maria R. Rizzo Michelangela Barbieri Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome Frontiers in Physiology ST2 protein heart failure internal cardioverter defibrillator ICDs' shocks hospitalization |
| title | Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome |
| title_full | Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome |
| title_fullStr | Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome |
| title_full_unstemmed | Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome |
| title_short | Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome |
| title_sort | stretch injury and inflammation markers evaluation to predict clinical outcomes after implantable cardioverter defibrillator therapy in heart failure patients with metabolic syndrome |
| topic | ST2 protein heart failure internal cardioverter defibrillator ICDs' shocks hospitalization |
| url | https://www.frontiersin.org/article/10.3389/fphys.2018.00758/full |
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