title: Elevated extracellular HSP70 (HSPA1A) level as an independent prognostic marker of mortality in patients with heart failure.
abstract: Predicting the survival of a patient with heart failure (HF) is a complex problem in clinical practice. Our previous study reported that extracellular HSP70 (HSPA1A) correlates with markers of heart function and disease severity in HF, but the predictive value of HSP70 is unclear. The goal of this study was to analyze extracellular HSP70 as predictive marker of mortality in HF. One hundred ninety-five patients with systolic heart failure were enrolled and followed up for 60 months. By the end of follow-up, 85 patients were alive (survivors) and 110 died (nonsurvivors). HSP70 (measured by ELISA in the serum) was elevated in nonsurvivors, compared with survivors (0.39 [0.27-0.59] vs. 0.30 [0.24-0.43] ng/ml, respectively, p = 0.0101). In Kaplan-Meier survival analysis higher HSP70 levels above median were associated with a significantly increased mortality. In multivariable survival models, we show that HSP70 level above the median is an age-, sex-, body mass index-, creatinine-, and NT-proBNP-independent predictor of 5-year mortality in HF. Extracellular HSP70 could prove useful for estimating survival in patients with HF.
authors.affiliation: Third Department of Internal Medicine, Semmelweis University, 1125, Budapest, Kútvölgyi út 4, Hungary, jzsiga04@gmail.com.
authors.forename: Zsigmond M
authors.initials: ZM
authors.lastname: Jenei
authors.forename: Tímea
authors.initials: T
authors.lastname: Gombos
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Förhécz
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Pozsonyi
authors.forename: István
authors.initials: I
authors.lastname: Karádi
authors.forename: Lívia
authors.initials: L
authors.lastname: Jánoskuti
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Prohászka
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D018840:HSP70 Heat-Shock Proteins / Q000097:blood*; D006333:Heart Failure / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D018840:HSP70 Heat-Shock Proteins; C490786:HSPA1A protein, human; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine
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