| Relation of circulating cardiac myosin light chain 1 isoform in stable severe congestive heart failure to survival and treatment with flosequinan. | |
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MedLine Citation:
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PMID: 12398964 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The myocardial contractile protein myosin light chain 1 isoform (MLC-1) is released into the circulation during myocyte necrosis and could thus be a marker of low-grade myocardial damage and of poor prognosis in patients with heart failure. Two hundred eighteen patients with stable heart failure (ejection fraction [EF] <35%) and in New York Heart Association (NYHA) class III to IV had MLC-1 measured at baseline and 1 month after being randomized to the direct vasodilator flosequinan or placebo. Patients were followed a mean of 302 +/- 142 days. The prognostic value of an increase in MLC-1 above the 98th percentile of normal controls was compared with that of conventional prognostic variables in heart failure. MLC-1 was increased in over half of patients at baseline and 1 month, and this was associated with increased age, NYHA class IV, and renal insufficiency. By Kaplan-Meier survival analysis, patients with a baseline increase in MLC-1 had a greater mortality (26%) than those without an increase (15%) (p = 0.043). A significant interaction among MLC-1, survival, and treatment was found (p = 0.043). In the placebo group, MLC-1 was associated with increased mortality (29% vs 12%, p = 0.025), whereas there was no significant difference among patients receiving flosequinan. In a multivariate logistic regression model including age, treatment, and left ventricular (LV) ejection fraction, the MLC-1 chain was most predictive of mortality (p = 0.049). Thus, circulating MLC-1 is elevated in over half of patients with stable severe heart failure, and this increase is associated with a poor prognosis. Flosequinan treatment eliminates this association, highlighting the complexity of the relation between cardiac myocyte damage, drug treatment, and mortality. |
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Authors:
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Mark S Hansen; Eric B Stanton; Yehia Gawad; Milton Packer; Bertram Pitt; Karl Swedberg; Jean L Rouleau; |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Evaluation Studies; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 90 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2002 Nov |
Date Detail:
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Created Date: 2002-10-25 Completed Date: 2002-12-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 969-73 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology of the University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Biological Markers / blood Double-Blind Method Female Follow-Up Studies Heart Failure / blood*, drug therapy*, mortality Humans Male Middle Aged Multivariate Analysis Myosin Light Chains / blood*, drug effects* North America Predictive Value of Tests Prospective Studies Quinolines / therapeutic use* Scandinavia Severity of Illness Index Stroke Volume / drug effects, physiology Survival Analysis Treatment Outcome Vasodilator Agents / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Myosin Light Chains; 0/Quinolines; 0/Vasodilator Agents; 76568-02-0/flosequinan |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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