title: Dipeptidyl peptidase IV and mortality after an acute heart failure episode.
abstract: BACKGROUND
  Dipeptidyl peptidase IV (DPP IV) is a key enzyme in B-type natriuretic peptide processing. DPP IV was never studied in human heart failure (HF). We aimed to measure DPP IV concentration in acute HF and determine its association with mortality.
  
  
  RESULTS
  Patients hospitalized with acute HF were eligible. We excluded patients with acute coronary syndromes. A discharge blood sample was collected from all patients and they were followed for a 6-month period. Outcome was HF death. Patients were compared across DPP IV quartiles. A Cox regression analysis was used to assess the prognostic power of DPP IV. We studied 164 patients. Median age was 78 years, 48.8% were men, and 63 had type 2 diabetes and 59.1% had left ventricular systolic dysfunction. Quartiles of DPP IV were <215.2; ≥ 215.2 and <269.3; ≥ 269.3 and <348.6; and ≥ 348.6 ng/mL; groups were homogenous between them. Seventeen patients died. Patients with DPP IV in the last quartile had a hazard ratio of HF death up to 6 months of 2.89, 95% confidence interval, 1.11-7.46. Association was B-type natriuretic peptide independent.
  
  
  CONCLUSIONS
  Discharge DPP IV ≥ 348.6 ng/mL conferred an approximately 3-fold higher risk of 6-month HF death. Further studies would be important to understand the role of DPP IV in HF.
authors.affiliation: Serviço de Medicina Interna, Centro Hospitalar São João, Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto, Porto, Portugal. pamlourenco@yahoo.com
authors.forename: Patrícia
authors.initials: P
authors.lastname: Lourenço
authors.forename: Fernando
authors.initials: F
authors.lastname: Friões
authors.forename: Nuno
authors.initials: N
authors.lastname: Silva
authors.forename: João Tiago
authors.initials: JT
authors.lastname: Guimarães
authors.forename: Paulo
authors.initials: P
authors.lastname: Bettencourt
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D018819:Dipeptidyl Peptidase 4 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000201:enzymology* / Q000453:epidemiology / Q000401:mortality*; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010351:Patient Discharge; D010865:Pilot Projects; D011174:Portugal / Q000453:epidemiology; D012307:Risk Factors; D016019:Survival Analysis; D015854:Up-Regulation; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology
chemical_list: D020097:Natriuretic Peptide, Brain; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4