title: Circulating Procollagen Type III N-Terminal Peptide and Mortality Risk in African Americans With Heart Failure.
abstract: BACKGROUND
  Procollagen type III N-terminal peptide (PIIINP) is a biomarker of cardiac fibrosis that is associated with heart failure prognosis in whites. Its prognostic significance in African Americans is unknown. We sought to determine whether PIIINP is associated with outcomes in African Americans with heart failure.
  
  
  RESULTS
  Blood was collected from 138 African Americans with heart failure for determining PIIINP and genetic ancestry, and patients were followed prospectively for death or hospitalization for heart failure. PIIINP was inversely correlated with West African ancestry (R(2) = 0.061; P = .010). PIIINP > 4.88 ng/mL was associated with all-cause mortality on univariate (hazard ratio [HR] 4.9, 95% confidence interval [CI] 2.2-11.0; P < .001) and multivariate (HR 5.8; 95% CI 1.9-17.3; P = .002) analyses over a median follow-up period of 3 years. We also observed an increased risk for the combined outcome of all-cause mortality or hospitalization for heart failure with PIIINP > 4.88 ng/mL on univariate (HR 2.6, 95% CI 1.6-5.0; P < .001) and multivariate (HR 2.4, 95% CI 1.2-4.7; P = .016) analyses.
  
  
  CONCLUSIONS
  High circulating PIIINP is associated with poor outcomes in African Americans with chronic heart failure, suggesting that PIIINP may be useful in identifying African Americans who may benefit from additional therapy to combat fibrosis as a means of improving prognosis.
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Ibrahim N
authors.initials: IN
authors.lastname: Mansour
authors.affiliation: Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Bress
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Vicki
authors.initials: V
authors.lastname: Groo
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Sahar
authors.initials: S
authors.lastname: Ismail
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Grace
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Shitalben R
authors.initials: SR
authors.lastname: Patel
authors.affiliation: Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Julio D
authors.initials: JD
authors.lastname: Duarte
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Rick A
authors.initials: RA
authors.lastname: Kittles
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Stamos
authors.affiliation: Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois. Electronic address: lcavallari@cop.ufl.edu.
authors.forename: Larisa H
authors.initials: LH
authors.lastname: Cavallari
mesh_terms: D000208:Acute Disease; D000328:Adult; D001741:Black or African American / Q000235:genetics*; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000208:ethnology / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010446:Peptide Fragments / Q000097:blood*; D011347:Procollagen / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide
keywords: African American; Heart failure; fibrosis