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Independent and additive prognostic ability of serum carboxy-terminal telopeptide of collagen type-I in heart failure patients: a multi-marker approach with high-negative predictive value to rule out long-term adverse events.
MedLine Citation:
PMID:  20479644     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Altered myocardial extracellular matrix turnover has been proposed as a major determinant of myocardial remodelling. Carboxy-terminal telopeptide of collagen type-I (CITP) represents a collagen type-I degradation-derived serum peptide. In this study we examined the independent and additive prognostic value of serum concentrations of CITP compared with well-known mortality predictors such as the N-terminal pro-brain natriuretic peptide (NT-proBNP) in chronic heart failure (CHF) patients. Methods: We studied 196 consecutive patients (126 male, mean age 69 ± 10 years), who were admitted for acute decompensation of the CHF syndrome. The study entry point was determined at the discharge of the patients after achieving a stable compensated status. The primary endpoint was cardiac mortality during a 12-month follow-up. Results: In the multivariate Cox proportional hazard model the levels of CITP remained a predictor of survival (hazards ratio 0.4 95% confidence interval 0.21-0.76, P = 0.005), independent of NT-proBNP levels. The stratified log-rank test (P < 0.001) showed that CHF patients characterized by low levels of both biomarkers had better survival (hazards ratio 0.12 95% confidence interval 0.04-0.35, P < 0.001) compared with patients characterized by high levels of both biomarkers. The negative predictive value of the combined measure for long-term adverse events was 94%. Conclusion: Serum levels of CITP were shown to be an independent and strong prognostic marker regarding survival in CHF patients. Furthermore, CITP levels had an additive prognostic value compared with NT-proBNP levels. These findings underline the detrimental role of myocardial fibrosis in the progression of heart failure and suggest a novel multi-marker approach for risk stratification in the CHF syndrome.
Authors:
Dimitrios N Tziakas; Georgios K Chalikias; Dimitrios Stakos; Sofia V Chatzikyriakou; Dimitrios Papazoglou; Konstantina Mitrousi; Asimina Lantzouraki; Adina Thomaidi; Harisios Boudoulas; Stavros Konstantinides
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Publication Detail:
Type:  Journal Article     Date:  2011-01-28
Journal Detail:
Title:  European journal of preventive cardiology     Volume:  19     ISSN:  2047-4881     ISO Abbreviation:  Eur J Prev Cardiolog     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101564430     Medline TA:  Eur J Prev Cardiolog     Country:  England    
Other Details:
Languages:  eng     Pagination:  62-71     Citation Subset:  IM    
Affiliation:
University Cardiology Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
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