Catestatin in Acutely Decompensated Heart Failure Patients: Insights from the CATSTAT-HF Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Measurement
2.3. Definitions
2.4. Echocardiography
2.5. Laboratory Analyses
2.6. Statistical Analysis
3. Results
3.1. Patients’ Baseline Characteristics
3.2. ADHF Patients with a History of MI and Those Without
3.3. CST Serum Levels Stratified by the History of MI and Across Different LVEF Phenotypes
3.4. Associations of Serum CST Levels with Clinical and Laboratory Parameters
3.5. Associations of Serum CST Levels with Echocardiographic Parameters
4. Discussion
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
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VARIABLE | Total Cohort N = 90 | ADHF without MI N = 50 | ADHF with MI N = 40 | p-Value * |
---|---|---|---|---|
Demographics and clinical profile | ||||
Age, years | 70.3 ± 10.2 | 69.8 ± 10.8 | 70.9 ± 9.6 | 0.610 |
Female sex | 47 (52.2) | 33 (66.0) | 14 (35.0) | 0.003 |
Body mass index, kg/m2 | 30.2 ± 4.2 | 30.8 ± 4.4 | 29.6 ± 3.9 | 0.182 |
Body surface area, m2 | 2.02 ± 0.18 | 2.02 ± 0.19 | 2.03 ± 0.17 | 0.792 |
Waist-to-hip ratio | 0.98 ± 0.08 | 0.97 ± 0.09 | 0.99 ± 0.06 | 0.095 |
Systolic blood pressure, mmHg | 137 ± 28 | 134 ± 23 | 140 ± 32 | 0.285 |
Diastolic blood pressure, mmHg | 80 ± 13 | 79 ± 12 | 82 ± 14 | 0.279 |
Heart rate at admission, beats/min | 95 ± 31 | 94 ± 28 | 96 ± 35 | 0.726 |
Heart rate at rest, beats/min | 88 ± 26 | 90 ± 28 | 84 ± 22 | 0.300 |
HF-related hospitalization event in a previous year | 36 (40.0) | 15 (30.0) | 21 (52.5) | 0.030 |
Pacemaker/ICD/CRT device | 13 (14.4) | 3 (6.0) | 10 (25.0) | 0.011 |
Left bundle branch block | 35 (38.9) | 19 (38.0) | 16 (40.0) | 0.847 |
NYHA functional class | 3.0 ± 0.62 | 2.9 ± 0.53 | 3.2 ± 0.69 | 0.031 |
CKD stage | 2.6 ± 0.9 | 2.3 ± 1.0 | 2.9 ± 0.8 | 0.004 |
LVEF ≤35%, biplane Simpson | 37 (41.1) | 16 (32.0) | 20 (50.0) | 0.083 |
SaO2 <90% at admission | 34 (37.8) | 18 (36.0) | 10 (40.0) | 0.777 |
Comorbidities and concomitant clinical conditions | ||||
Diabetes mellitus | 37 (41.1) | 17 (34.0) | 20 (50.0) | 0.125 |
Anemia | 36 (40.0) | 12 (24.0) | 14 (35.0) | 0.253 |
Obesity | 38 (42.2) | 25 (55.6) | 13 (35.1) | 0.065 |
Hyperuricemia | 75 (83.3) | 40 (83.3) | 35 (87.5) | 0.193 |
Dyslipidemia | 60 (66.6) | 33 (66.6) | 27 (67.5) | 0.743 |
Chronic obstructive pulmonary disease | 21 (23.3) | 14 (28.0) | 7 (17.5) | 0.242 |
Chronic kidney disease | 46 (51.1) | 21 (42.0) | 25 (62.5) | 0.053 |
Arterial hypertension | 84 (93.3) | 45 (90.0) | 39 (97.5) | 0.156 |
Atrial fibrillation | 50 (55.6) | 28 (56.0) | 22 (55.0) | 0.924 |
Peripheral artery disease | 19 (21.1) | 9 (18.0) | 10 (25.0) | 0.419 |
Smoker, present or former | 34 (37.8) | 14 (28.0) | 20 (50.0) | 0.032 |
History of stroke or transient ischemic attack | 7 (7.8) | 4 (8.0) | 3 (7.5) | 0.930 |
Pharmacotherapy | ||||
ACE inhibitor or ARB | 70 (77.8) | 41 (82.0) | 29 (72.5) | 0.245 |
Sacubitril-valsartan | 24 (26.7) | 11 (22.0) | 13 (32.5) | 0.154 |
β-blocker | 81 (90.0) | 43 (86.0) | 38 (95.0) | 0.235 |
Ca2+ channel blocker | 13 (14.4) | 9 (18.0) | 4 (10.0) | 0.305 |
MRA | 42 (46.7) | 24 (48.0) | 18 (45.0) | 0.953 |
Diuretics | 82 (91.1) | 45 (90.0) | 37 (92.5) | 0.274 |
Digoxin | 18 (20.0) | 9 (18.0) | 9 (22.5) | 0.554 |
Aspirin | 35 (38.9) | 13 (26.0) | 22 (55.0) | 0.005 |
Warfarin | 23 (25.6) | 14 (28.0) | 9 (22.5) | 0.617 |
NOAC | 22 (24.4) | 13 (26.0) | 9 (22.5) | 0.821 |
Statin | 33 (36.7) | 14 (28.0) | 19 (47.5) | 0.035 |
Variable | Total Cohort N = 90 | ADHF without Prior MI N = 50 | ADHF with Prior MI N = 40 | p-Value * |
---|---|---|---|---|
Laboratory values | ||||
Sodium, mmol/L | 138.9 ± 3.7 | 139.0 ± 4.1 | 138.7 ± 3.2 | 0.725 |
Potassium, mmol/L | 4.2 ± 0.4 | 4.1 ± 0.4 | 4.2 ± 0.5 | 0.252 |
Creatinine, µmol/L | 117.6 ± 59.5 | 99.9 ± 42.0 | 139.8 ± 70.4 | 0.001 |
BUN, mmol/L | 4.9 ± 2.6 | 4.5 ± 2.5 | 5.4 ± 2.8 | 0.132 |
eGFR, mL/min/1.73 m2 | 57.3 ± 24.9 | 63.8 ± 25.7 | 49.2 ± 21.7 | 0.005 |
Uric acid, µmol/L | 535 ± 165 | 511 ± 179 | 565 ± 143 | 0.130 |
Albumin, g/L | 38.7 ± 4.1 | 38.6 ± 4.1 | 38.8 ± 4.2 | 0.849 |
Total proteins, g/L | 68.2 ± 7.2 | 67.5 ± 7.8 | 69.0 ± 6.3 | 0.314 |
Hemoglobin, g/L | 133.4 ± 19.2 | 134.1 ± 18.7 | 132.6 ± 19.9 | 0.706 |
WBC count, ×109/L | 8.08 ± 2.59 | 7.73 ± 2.49 | 8.51 ± 2.66 | 0.156 |
Erythrocytes, ×1012/L | 4.48 ± 0.69 | 4.46 ± 0.69 | 4.51 ± 0.71 | 0.775 |
Thrombocytes, ×109/L | 214 ± 60 | 217 ± 61 | 209 ± 58 | 0.522 |
Lymphocytes, ×109/L | 1.50 ± 1.35 | 1.49 ± 0.70 | 1.50 ± 0.68 | 0.970 |
Neutrophils, ×109/L | 5.64 ± 2.18 | 5.41 ± 2.11 | 5.92 ± 2.24 | 0.278 |
Fasting glucose, mmol/L | 8.2 ± 3.0 | 7.7 ± 2.6 | 8.8 ± 3.4 | 0.091 |
HbA1c, % | 6.61 ± 1.26 | 6.33 ± 0.94 | 6.97 ± 1.50 | 0.017 |
NT-proBNP, pg/mL | 3586 (1361–7787) | 2286 (1110–5976) | 5277 (3079–12004) | 0.008 |
hs-cTnI, ng/L | 22.9 (11.6–49.0) | 16.0 (10.0–27.3) | 35.8 (19.3–84.2) | 0.001 |
CRP, mg/L | 8.4 (4.9–20.5) | 7.9 (4.7–17.7) | 11.5 (6.6–30.6) | 0.110 |
D-dimer, mg/L | 1.62 ± 1.35 | 1.55 ± 1.33 | 1.72 ± 1.40 | 0.718 |
Triglycerides, mmol/L | 1.56 ± 0.64 | 1.51 ± 0.64 | 1.61 ± 0.65 | 0.471 |
Total cholesterol, mmol/L | 4.4 ± 1.3 | 4.7 ± 1.3 | 4.1 ± 1.3 | 0.030 |
HDL cholesterol, mmol/L | 1.0 (0.8–1.2) | 1.0 (0.9–1.2) | 0.9 (0.8–1.1) | 0.023 |
LDL cholesterol, mmol/L | 2.7 ± 1.1 | 2.9 ± 1.1 | 2.4 ± 1.1 | 0.029 |
Variable | Total Cohort N = 90 | ADHF without Prior MI N = 50 | ADHF with Prior MI N = 40 | p-Value * |
---|---|---|---|---|
LVEF, biplane Simpson, % | 43.4 ± 16.4 | 46.3 ± 15.8 | 39.9 ± 16.6 | 0.066 |
LV mass, g | 254.4 ± 95.7 | 250.2 ± 93.9 | 258.5 ± 97.5 | 0.686 |
LVMI, g/m2 | 119.0 ± 47.3 | 117.3 ± 46.5 | 120.7 ± 48.1 | 0.744 |
LV EDd, mm | 57.9 ± 9.4 | 56.9 ± 8.5 | 58.9 ± 10.4 | 0.322 |
LV ESd, mm | 42.6 ± 12.1 | 40.9 ± 11.3 | 44.6 ± 12.9 | 0.152 |
IVSd, mm | 11 (10–13) | 11 (10–13.5) | 11 (10–12) | 0.405 |
LV PWd, mm | 10.9 ± 2.0 | 11.0 ± 1.9 | 10.9 ± 2.1 | 0.734 |
FS, % | 27.3 ± 11.5 | 28.4 ± 11.4 | 25.9 ± 11.6 | 0.326 |
LV EDV, mL/m2 ** | 85.2 ± 32.3 | 80.4 ± 26.4 | 91.1 ± 38.0 | 0.142 |
LV ESV, mL/m2 ** | 45.0 ± 29.7 | 40.0 ± 25.4 | 51.3 ± 33.6 | 0.096 |
LA diameter, mm | 49.9 ± 8.9 | 49.5 ± 9.7 | 50.3 ± 7.7 | 0.685 |
Aortic root diameter, mm | 33.8 ± 5.1 | 33.3 ± 5.3 | 34.5 ± 4.9 | 0.295 |
LA/Ao ratio | 1.49 ± 0.28 | 1.49 ± 0.31 | 1.48 ± 0.24 | 0.757 |
Variable | Univariate β | p-Value * | B | SE | β | t | p-Value ** |
---|---|---|---|---|---|---|---|
NYHA class | 0.533 | <0.001 | 0.361 | 0.082 | 0.491 | 4.257 | <0.001 |
WHR | −0.335 | 0.012 | −1.360 | 0.615 | −0.237 | −2.231 | 0.026 |
Heart rate at admission, bpm | −0.164 | 0.125 | −0.933 | 0.418 | −0.201 | −1.960 | 0.036 |
Heart rate at rest, bpm | −0.189 | 0.098 | −0.951 | 0.451 | −0.242 | −2.177 | 0.030 |
Total cholesterol, mmol/L | −0.108 | 0.268 | |||||
Triglycerides, mmol/L | −0.201 | 0.101 | |||||
HDL-c, mmol/L | −0.082 | 0.508 | |||||
LDL-c, mmol/L | −0.272 | 0.019 | −0.089 | 0.040 | −0.231 | −2.123 | 0.029 |
Non-HDL cholesterol, mmol/L | −0.281 | 0.014 | −0.094 | 0.045 | −0.237 | −2.298 | 0.026 |
NT-proBNP, pg/mL | −0.193 | 0.074 | |||||
hs-cTnI, ng/L | −0.260 | 0.015 | −0.080 | 0.111 | −0.221 | −0.799 | 0.030 |
CRP, mg/L | 0.147 | 0.490 | |||||
D-dimer, mg/L | −0.094 | 0.770 | |||||
Glucose, fasting, mmol/L | −0.165 | 0.159 | |||||
HbA1c, % | −0.264 | 0.023 | −0.085 | 0.039 | −0.235 | −1.248 | 0.027 |
Variable | Univariate β | p-Value * | B | SE | β | t | p-Value ** |
---|---|---|---|---|---|---|---|
LVEF, % | 0.323 | 0.010 | 0.700 | 0.299 | 0.271 | 2.350 | 0.022 |
LV mass, g | −0.312 | 0.019 | −0.001 | 0.001 | −0.249 | −2.185 | 0.031 |
LVMI, g/m2 | −0.301 | 0.022 | −0.002 | 0.001 | −0.237 | −2.488 | 0.015 |
LV EDd, mm | −0.463 | <0.001 | −0.020 | 0.005 | −0.341 | −3.203 | 0.001 |
LV ESd, mm | −0.411 | <0.001 | −0.013 | 0.004 | −0.311 | −2.762 | 0.005 |
IVSd, mm | 0.181 | 0.139 | |||||
LV PWd, mm | −0.165 | 0.180 | |||||
LV EDV, indexed to BSA, mL/m2 | −0.375 | <0.001 | −0.002 | 0.001 | −0.324 | −3.211 | 0.002 |
LV ESV, indexed to BSA, mL/m2 | −0.349 | <0.001 | −0.003 | 0.001 | −0.328 | −3.157 | 0.002 |
LA diameter, mm | −0.297 | 0.010 | −0.012 | 0.005 | −0.262 | −2.415 | 0.019 |
Aortic root diameter, mm | −0.070 | 0.574 | |||||
LA/Ao ratio | −0.032 | 0.795 | |||||
LAEDV, mL | −0.171 | 0.251 | |||||
LAVI, mL/m2 | −0.233 | 0.101 | |||||
Fractional shortening, % | 0.292 | 0.021 | 0.011 | 0.003 | 0.255 | 2.198 | 0.029 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Borovac, J.A.; Glavas, D.; Susilovic Grabovac, Z.; Supe Domic, D.; D’Amario, D.; Bozic, J. Catestatin in Acutely Decompensated Heart Failure Patients: Insights from the CATSTAT-HF Study. J. Clin. Med. 2019, 8, 1132. https://doi.org/10.3390/jcm8081132
Borovac JA, Glavas D, Susilovic Grabovac Z, Supe Domic D, D’Amario D, Bozic J. Catestatin in Acutely Decompensated Heart Failure Patients: Insights from the CATSTAT-HF Study. Journal of Clinical Medicine. 2019; 8(8):1132. https://doi.org/10.3390/jcm8081132
Chicago/Turabian StyleBorovac, Josip A., Duska Glavas, Zora Susilovic Grabovac, Daniela Supe Domic, Domenico D’Amario, and Josko Bozic. 2019. "Catestatin in Acutely Decompensated Heart Failure Patients: Insights from the CATSTAT-HF Study" Journal of Clinical Medicine 8, no. 8: 1132. https://doi.org/10.3390/jcm8081132