Differences in the predictive value of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in advanced ischemic and non-ischemic heart failure.
OBJECTIVE
To assess the prognostic value of the pro-apoptotic, but also cell growth-inducing molecule soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) in heart failure (HF).


METHODS
We assayed sTWEAK levels in 351 patients with advanced HF (non-ischemic: 130, ischemic: 221). During a median follow-up of 4.9 years, 195 patients (56%) died.


RESULTS
sTWEAK concentrations were associated with extended survival in patients with non-ischemic (P=0.022), but not with ischemic HF (P=0.82). The inverse association in non-ischemic HF remained significant in a multivariable Cox regression model (P=0.025) with a hazard ratio of 0.40 (95% confidence interval: 0.21-0.77) comparing the third to the first tertile (P=0.007).


CONCLUSIONS
Low sTWEAK levels independently predict mortality in advanced non-ischemic HF. sTWEAK-induced proliferation of cardiomyocytes may explain its impact on suvival. The different prognostic value of sTWEAK in ischemic and non-ischemic HF may point towards distinct pathogenic pathways determining the course of disease.
Richter
Bernhard
B
Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Rychli
Kathrin
K
Hohensinner
Philipp J
PJ
Berger
Rudolf
R
Mörtl
Deddo
D
Neuhold
Stephanie
S
Zorn
Gerlinde
G
Huber
Kurt
K
Maurer
Gerald
G
Wojta
Johann
J
Pacher
Richard
R
Hülsmann
Martin
M
Niessner
Alexander
A
D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D000074049:Cytokine TWEAK; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D048069:Tumor Necrosis Factors / Q000097:blood*
D000074049:Cytokine TWEAK; C109743:TNFSF12 protein, human; D048069:Tumor Necrosis Factors