title: Differences in the predictive value of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in advanced ischemic and non-ischemic heart failure.
abstract: 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.
authors.affiliation: Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Richter
authors.forename: Kathrin
authors.initials: K
authors.lastname: Rychli
authors.forename: Philipp J
authors.initials: PJ
authors.lastname: Hohensinner
authors.forename: Rudolf
authors.initials: R
authors.lastname: Berger
authors.forename: Deddo
authors.initials: D
authors.lastname: Mörtl
authors.forename: Stephanie
authors.initials: S
authors.lastname: Neuhold
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Zorn
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Richard
authors.initials: R
authors.lastname: Pacher
authors.forename: Martin
authors.initials: M
authors.lastname: Hülsmann
authors.forename: Alexander
authors.initials: A
authors.lastname: Niessner
mesh_terms: 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*
chemical_list: D000074049:Cytokine TWEAK; C109743:TNFSF12 protein, human; D048069:Tumor Necrosis Factors