Predictive Value of Circulating SPARC-Related protein Osteonectin in Patients with Symptomatic Moderate-to-Severe Ischemic-Induced Chronic Heart Failure

Abstract

Aim: To evaluate the prognostic value of circulating osteonectin for cumulative survival and hospitalization in patients with ischemic chronic heart failure (CHF).

Methods: One hundred fifty four patients with ischemic symptomatic moderate-to-severe CHF were prospectively enrolled at discharge from the hospital. Observation period was up to 3 years (156 weeks). Blood samples for hematology, chemistry, and biomarker measurements were collected at baseline prior to study entry. ELISA method for measurement of circulating osteonectin (OSN) was used.

Results: During a median follow-up of 2.18 years we identified 21 deaths and 106 readmissions. Medians of circulating levels of OSN in survivors patient and subjects who died were 670.96 ng/mL (95% confidence interval [CI] = 636.53-705.35 ng/mL) and 907.84 ng/mL (95% CI = 878.02-937.60 ng/mL). Receive Operation Characteristic curve analysis has shown the best balanced cutoff point of OSN concentration for cumulative survival equal 845.15 ng/mL. A significantly divergence of Kaplan-Meier survival curves constructed for patients with high (> 845.15 ng/mL) and low (<845.15 ng/mL) concentrations of OSN was found. Circulating OSN independently predicted all-cause mortality (OR = 1.23; 95% CI = 1.10–1.36; P < 0.001), CHF-related death (OR = 1.46; 95% CI 1.22–1.80; P < 0.001), and also CHF-related readmission (OR = 1.92; 95% CI = 1.77 – 2.45; P<0.001) within 3 year of follow-up period.

Conclusion: Increased circulating SPARC family member OSN associates with increased 3-year CHF-related death, all-cause mortality, and risk for readmission due to CHF.