Predictive value of advanced glycation end products for the development of post-infarction heart failure: a preliminary report.
BACKGROUND
Since post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development.


METHODS
A prospective clinical study in patients after first acute coronary syndrome was conducted. The follow-up period was consisted in 1 year. In 194 patients consecutively admitted in the coronary unit for myocardial infarct fluorescent AGE levels were measured. The association between glycaemic parameters and the development of post-infarction HF were analyzed in those patients. Finally, we identified the variables with independent predictor value by performing a multivariate analysis of hazard ratio for Cox regression.


RESULTS
Eleven out of 194 patients (5.6%) developed HF during follow-up (median: 1.0 years [0.8 - 1.5 years]). Even though basal glucose, fructosamine and glycated haemoglobin were significant predictive factors in the univariate analysis, after being adjusted by confounding variables and AGE they lost their statistical signification. Only AGE (Hazard Ratio 1.016, IC 95%: 1.006-1.026; p<0,001), together with NT-proBNP and the infarct extension were predictors for post-infarction HF development, where AGE levels over the median value 5-fold increased the risk of HF development during follow-up.


CONCLUSIONS
AGE are an independent marker of post-infarction HF development risk.
Instituto de Investigación Sanitaria Santiago de Compostela, Santiago de Compostela, Spain.
Sergio
S
Raposeiras-Roubín
Bruno K
BK
Rodiño-Janeiro
Beatriz
B
Paradela-Dobarro
Lilian
L
Grigorian-Shamagian
José M
JM
García-Acuña
Pablo
P
Aguiar-Souto
Michel
M
Jacquet-Hervet
María V
MV
Reino-Maceiras
Ezequiel
E
Alvarez
José R
JR
González-Juanatey
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced / Q000097:blood*; D006333:Heart Failure / Q000097:blood* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications* / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013050:Spectrometry, Fluorescence; D013997:Time Factors
D015415:Biomarkers; D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; C517652:hemoglobin A1c protein, human; C109794:pro-brain natriuretic peptide (1-76)