Key result
Urinary angiotensinogen levels were significantly higher in HFrEF patients with ≥2 hospitalizations in the previous year compared to those with <2 hospitalizations (193.2 vs 99 µg/g), but UAGT was not an independent predictor of re-hospitalization.
Why the study?
Does urinary angiotensinogen (UAGT) level predict repeated hospitalization in patients with HFrEF?
Observational (n=63)
No
Does urinary angiotensinogen (UAGT) level predict repeated hospitalization in patients with HFrEF?
Although urinary angiotensinogen levels are elevated in HFrEF patients with poor functional status and frequent hospitalizations, it does not serve as an independent predictor of re-hospitalization.
UAGT should not guide re-hospitalization risk assessment in HFrEF; leaves open its value as a severity marker for prospective validation.
OBJECTIVE: Heart failure (HF) is a clinical syndrome resulting from structural or functional damages. Although clinical trials have shown that the plasma renin-angiotensin system (RAS) activation decreases HF functional status and increases hospitalization for HF patients, the effect of intrarenal RAS activity is still unknown. In this study, we investigated the relationship between the New York Heart Association (NYHA) class, duration, and number of hospitalizations in the previous year and urinary angiotensinogen (UAGT) in patients with HF with reduced ejection fraction (HFrEF). METHODS: This study included 85 patients who had an ejection fraction of <40% and were receiving optimal medical treatment. Among these, 22 were excluded from the study for various reasons. Demographically and biochemically, the remaining 63 patients were compared according to the NYHA functional classes and re-hospitalization status. RESULTS: When the groups were compared in terms of N-terminal pro-B-type natriuretic peptide (NT-proBNP), UAGT, and high-sensitivity C-reactive protein (Hs-CRP), it was found that these parameters were significantly higher in patients who were hospitalized more than two times in the previous year [p<0.001; p=0.007; p<0.001, respectively]. There was a significant correlation between number of hospitalizations and NT-proBNP (r=0.507, p<0.001), Hs-CRP (r=0.511, p<0.001), hemoglobin (r=-0.419, p=0.001), serum sodium (r=-0.26, p=0.04), and systolic blood pressure (r=-0.283, p=0.02). When the independence of multiple correlations was assessed using multiple linear regression analysis, NT-proBNP, Hs-CRP, and hemoglobin levels were independent predictors of re-hospitalization, but this was not the same for UAGT. CONCLUSION: Although UAGT levels are high in patients with poor NYHA functional class and repeated hospitalizations, this marker is not valuable for predicting repeated hospitalization in patients with HFrEF.
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Özcan Örsçelik (2018) conducted an observational in Heart failure with reduced ejection fraction (HFrEF) (n=63). Urinary angiotensinogen (UAGT) vs. Lower UAGT levels was evaluated on Urinary angiotensinogen (UAGT/UCre) levels in patients with ≥2 hospitalizations vs <2 hospitalizations in the previous year (p=0.007). Urinary angiotensinogen levels were significantly higher in HFrEF patients with ≥2 hospitalizations in the previous year compared to those with <2 hospitalizations (193.2 vs 99 µg/g), but UAGT was not an independent predictor of re-hospitalization.
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