Circulating SERPINA3 levels > 316 μg/mL were associated with increased all-cause mortality (HR 2.4; 95% CI 1.5-3.9; P=0.0002) in patients with de novo or worsened heart failure.
Cohort (n=487)
Do elevated circulating SERPINA3 levels predict all-cause mortality and unplanned cardiovascular readmission in patients with de novo or worsened heart failure?
Elevated circulating SERPINA3 levels (>316 μg/mL) independently predict increased mortality and unplanned cardiac readmissions in patients with de novo or worsened heart failure, providing incremental prognostic value over established clinical predictors.
Effect estimate: HR 2.4 (95% CI 1.5-3.9)
p-value: p=0.0002
AIMS: We investigated the prognostic relevance of serpin peptidase inhibitor, clade A member 3 (SERPINA3) in patients admitted with a de novo or worsened heart failure (HF). METHODS AND RESULTS: In the first stage, 83 HF-related left ventricular (LV) transcripts were examined in patients with congestive cardiomyopathy (CCMP, n = 44) who died within 5 years and compared with age-matched and haemodynamically matched CCMP survivors (n = 39) and controls with normal LV function (n = 17). Among 14 differentially expressed transcripts, myocardial gene and circulating SERPINA3 levels were up-regulated in non-survivors vs. survivors (2. 40 ± 3. 66 vs. 0. 36 ± 0. 22 units, P 316 μg/mL were associated with increased all-cause mortality hazard ratio HR 95% confidence interval (CI): 2. 4 1. 5-3. 9, P = 0. 0002 and its composite with unplanned cardiovascular readmission HR (95% CI): 2. 0 (1. 2-3. 3), P = 0. 004. Patients with elevated SERPINA3 levels and elevated either N-terminal pro brain natriuretic peptide or ST2 showed worse freedom from both endpoints. In a multivariate analysis, including established clinical risk factors, SERPINA3 remained independent predictor of all-cause mortality together with age, gender, ST2, glomerular filtration, and pulmonary capillary wedge pressure. CONCLUSION: In patients with a de novo or worsened HF, increased SERPINA3 levels > 316 μg/mL are associated with increased mortality or unplanned cardiac readmission. Elevated SERPINA3 levels on top of established clinical predictors appear to identify a subgroup of HF patients at higher mortality risk. Prospective studies should further validate its value in prognostic stratification of HF.
Delrue et al. (Mon,) conducted a cohort in De novo or worsened heart failure (n=487). Circulating SERPINA3 was evaluated on All-cause mortality (HR 2.4, 95% CI 1.5-3.9, p=0.0002). Circulating SERPINA3 levels > 316 μg/mL were associated with increased all-cause mortality (HR 2.4; 95% CI 1.5-3.9; P=0.0002) in patients with de novo or worsened heart failure.