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Osteopontin and Galectin‐3 Predict the Risk of Ventricular Tachycardia and Fibrillation in Heart Failure Patients with Implantable Defibrillators
Author(s) -
FRANCIA PIETRO,
ADDUCI CARMEN,
SEMPRINI LORENZO,
BORRO MARINA,
RICOTTA AGNESE,
SENSINI ISABELLA,
SANTINI DARIA,
CAPRINOZZI MASSIMO,
BALLA CRISTINA,
SIMMACO MAURIZIO,
VOLPE MASSIMO
Publication year - 2014
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12364
Subject(s) - medicine , cardiology , heart failure , hazard ratio , ventricular tachycardia , fibrillation , ventricular fibrillation , galectin 3 , clinical endpoint , coronary artery disease , tachycardia , atrial fibrillation , confidence interval , clinical trial
OPN and Gal‐3 Predict VT/VF in Heart Failure Patients Background Myocardial extracellular matrix remodelling provides electrical heterogeneity entailing ventricular tachycardia/fibrillation (VT/VF) in heart failure (HF) patients. Osteopontin (OPN) and Galectin‐3 (Gal‐3) are fibrosis markers and may reflect the extension of the arrhythmogenic substrate. We assessed whether plasma OPN and Gal‐3 predict the risk of sustained VT/VF in a cohort of HF patients with implantable cardioverter‐defibrillator (ICD). Methods A total of 75 HF patients underwent pre‐ICD implantation clinical evaluation and assessment of plasma OPN and Gal‐3. The primary endpoint was the time to the occurrence of the first sustained VT/VF. Hazard ratios (HR) were derived from Cox proportional‐hazards analysis. Results Patients with coronary artery disease (CAD) had higher plasma OPN (79.8 ± 44.0 ng/mL vs. 66.0 ± 31.8 ng/mL; P = 0.04). Both Gal‐3 (r = −0.38; P = 0.01) and OPN (r = −0.27; p = 0.01) were negatively related to estimated glomerular filtration rate. After 29 ± 17 months, 20 patients (27%) reached the primary endpoint. Patients with VT/VF had higher plasma OPN and Gal‐3 (97.4 ± 51.7 ng/mL vs. 65.9 ± 31.3 ng/mL; P = 0.002 and 19.7 ± 8.5 ng/mL vs. 16.2 ± 6.2 ng/mL; P = 0.05). In univariate analysis, OPN (log‐OPN, HR: 32.4; 95%CI: 3.9–264.7; P = 0.001) and Gal‐3 (HR: 1.05; 95%CI: 1.00–1.11; P = 0.04) predicted sustained VT/VF. In multivariable analysis, both OPN (HR: 41.4; 95%CI: 3.8–441.9; P = 0.002) and Gal‐3 (HR: 1.06; 95%CI: 1.00–1.12; P = 0.03) retained their prognostic power after correction for age, sex, history of MI, EF, NYHA class, eGFR, use of ACE‐I, and amiodarone. Conclusions Plasma OPN and Gal‐3 predict sustained VT/VF in HF patients at high risk for SCD. Larger prospective studies should outline the role of these biomarkers in predicting SCD on top of conventional risk stratification.