Aim: To evaluate the prognostic value of circulating osteopontin for recurrent hospitalization in patients with ischemic chronic heart failure (CHF).
Methods: A total of 154 patients with ischemic symptomatic moderate-to-severe CHF were enrolled in the study on discharge from the hospital. Observation period was up to 3 years. Blood samples for biomarkers measurements were collected. ELISA methods for measurements of circulating level of all biomarkers were used. Osteopontin (OPN) combined with galectin-3 (Gal-3) and NT-pro-brain natriuretic peptide (NT-pro-BNP) in comparison with NT-pro-BNP or Gal-3 alone for recurrent hospitalization cases due to advanced CHF was tested. Additionally, all-cause mortality, and CHF-related death were tested.
Results: Compared with NT-pro- BNP and Gal-3, OPN was of superior prognostic value in CHF patients for recurrent hospitalization (OR=1.36; 95%CI = 1.16 – 2.54; P<0.001 and OR=1.21; 95% CI=1.02-1.44; P<0.001 respectively), but not with CHF-related death (OR = 1.02; 95% CI 0.80–1.20; P = 0.42 and OR = 1.03; 95% CI 0.86–1.15; P = 0.46 respectively) and all-cause mortality (OR = 1.01; 95% CI 0.76–1.11; P = 0.63 and OR = 1.04; 95% CI 0.86–1.13; P = 0.60 respectively).
Adding OPN to NT-pro- BNP and Gal-3 in a prediction model suggesting that three biomarkers when compared with each alone were subtle improved discrimination for recurrent hospitalization (OR = 2.16; 95% CI 1.77–2.64; P < 0.001), CHF-related death (OR = 1.95; 95% CI 1.88–2.32; P < 0.001), and all-cause mortality (OR = 1.88; 95% CI = 1.72–2.21; P < 0.001).
Conclusion: Increased circulating OPN was associated with greater risk for recurrent hospitalization due to advanced CHF, but not with CHF-related death and all-cause mortality. OPN identified CHF patients with high 3-year all-cause mortality and CHF-related death, and added prognostic value to combined NT-pro-BNP and Gal-3
