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High serum erythropoietin levels are related to heart failure development in subjects from the general population with albuminuria: data from PREVEND
Author(s) -
Grote Beverborg Niels,
van der Wal Haye H.,
Klip IJsbrand T.,
Voors Adriaan A.,
de Boer Rudolf A.,
van Gilst Wiek H.,
van Veldhuisen Dirk J.,
Gansevoort Ron T.,
Hillege Hans L.,
van der Harst Pim,
Bakker Stephan J.L.,
van der Meer Peter
Publication year - 2016
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.484
Subject(s) - medicine , hazard ratio , albuminuria , interquartile range , heart failure , erythropoietin , population , endocrinology , cardiology , confidence interval , gastroenterology , kidney disease , environmental health
Aims In patients with heart failure ( HF ), serum erythropoietin ( EPO ) levels are elevated and associated with disease severity and outcome. Whether endogenous EPO levels are prospectively associated with the development of HF or cardiovascular events in the general population is unknown. Methods and results Serum EPO levels were measured at baseline in 6686 subjects enrolled in the Prevention of REnal and Vascular ENd ‐stage Disease ( PREVEND ) study. Mean age (± SD ) was 53 ± 12 years, 49.8% were male, and the median (interquartile range) EPO level was 7.7 (5.9–10.2) IU /L. During a median follow‐up of 8.3 (7.7–8.8) years, 209 (3.1%) subjects were newly diagnosed with HF , 97 (1.5%) died of a cardiovascular cause, and 386 (6.0%) subjects had a non‐fatal cardiovascular event (277 cardiac events and 93 strokes). Each doubling of EPO level was multivariably associated with new‐onset HF [hazard ratio ( HR ) 1.32, 95% confidence interval ( CI ) 1.03–1.69, P = 0.031]. EPO levels showed interaction with urinary albumin excretion ( P = 0.006) and were only associated with HF in subjects with albuminuria ( HR 1.51, 95% CI 1.13–2.03, P = 0.005). There was an independent association of EPO levels with stroke in women ( HR 1.82, 95% CI 1.24–2.65, P = 0.002), but not in men. No association was observed for EPO levels with other cardiovascular events or cardiovascular mortality. Conclusion High serum EPO levels are independently associated with an increased risk of new‐onset HF in subjects with albuminuria. More research into the pathophysiological mechanisms linking EPO levels to HF is needed to understand this association.