Key result
Plasma CTRP3 levels below the 25th percentile independently predicted increased total mortality (HR 1.93) and hospitalizations in patients with heart failure with reduced ejection fraction.
Why the study?
Assessing stability in heart failure remains difficult, creating a need for novel means of stratifying disease severity.
Are decreased levels of CTRP3 and CTRP9 associated with increased mortality and hospitalization in patients with HFrEF?
Cohort (n=344)
No
Are decreased levels of CTRP3 and CTRP9 associated with increased mortality and hospitalization in patients with HFrEF?
Plasma concentrations of CTRP3 and CTRP9 are significantly decreased in patients with HFrEF and lower levels independently predict increased all-cause mortality and re-hospitalization.
Answers are grounded in this paper and cite their sources.
Lower CTRP3 levels were associated with higher mortality in HFrEF; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: Biochemical marker has revolutionized the approach to the diagnosis of heart failure. However, it remains difficult to assess stability of the patient. As such, novel means of stratifying disease severity are needed. C1q/TNF-Related Protein 3 (CTRP3) and C1q/TNF-Related Protein 9 (CTRP9) are novel adipokines that contribute to energy homeostasis with additional anti-inflammatory and anti-ischemic properties. The aim of our study is to evaluate concentrations of CTRP3 and CTRP9 in patients with HFrEF (heart failure with reduced ejection fraction) and whether associated with mortality. METHODS: Clinical data and plasma were obtained from 176 healthy controls and 168 patients with HFrEF. CTRP3 and CTRP9 levels were evaluated by enzyme-linked immunosorbent assay. RESULTS: Both CTRP3 and CTRP9 concentrations were significantly decreased in the HFrEF group compared to the control group (p < 0.001). Moreover, patients with higher New York Heart Association class had significantly lower CTRP3 or CTRP9 concentrations. Correlation analysis revealed that CTRP3 and CTRP9 levels were positively related with LVEF% (CTRP3, r = 0.556, p < 0.001; CTRP9, r = 0.526, p < 0.001) and negatively related with NT-proBNP levels (CTRP3, r = - 0.454, p < 0.001; CTRP9, r = - 0.483, p < 0.001). After a follow up for 36 months, after adjusted for age, LVEF and NT-proBNP, we observed that CTRP3 or CTRP9 levels below the 25th percentile was a predictor of total mortality (CTRP3,HR:1.93,95%CI1.03~3.62,P = 0.042;CTRP9,HR:1.98,95%CI:1.02~3.85,P = 0.044) and hospitalizations (CTRP3,HR:2.34,95% CI:1.43~3.82,P = 0.001;CTRP9,HR:2.67,95%CI:1.58~4.50,P < 0.001). CONCLUSIONS: CTRP3 and CTRP9 are decreased in patients with HFrEF, proportionate to disease severity, and each is associated with increased morbidity and mortality. TRIAL REGISTRATION: NCT01372800 . Registered May 2011.
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Gao et al. (2019) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=344). CTRP3 levels below the 25th percentile vs. CTRP3 levels above the 25th percentile was evaluated on Total mortality (HR 1.93, 95% CI 1.03-3.62, p=0.042). Plasma CTRP3 levels below the 25th percentile independently predicted increased total mortality (HR 1.93) and hospitalizations in patients with heart failure with reduced ejection fraction.
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