title: 8-Hydroxy-2-deoxyguanosine levels and heart failure: A systematic review and meta-analysis of the literature.
abstract: OBJECTIVE
  The generation of reactive oxygen species (ROS) plays an important role in the etiology of several pathological conditions. High levels of 8-hydroxy-2-deoxyguanosine (8-OHdG), a biomarker of oxidative damage of DNA, have been found in patients with heart failure (HF). We performed a meta-analysis of the literature to investigate the association between 8-OHdG levels and HF.
  
  
  RESULTS
  A systematic search was performed in the PubMed, Web of Science, Scopus, EMBASE databases and studies evaluating 8-OHdG levels in HF patients and controls were included. Differences between cases and controls were expressed as standard mean difference (SMD) or mean difference (MD) with pertinent 95% confidence intervals (95%CI). Impact of clinical and demographic features on effect size was assessed by meta-regression. Six studies (446 HF patients and 140 controls) were included in the analysis. We found that HF patients showed higher 8-OHdG levels than controls (SMD:0.89, 95%CI: 0.68, 1.10). The difference was confirmed both in studies in which 8-OHdG levels were assessed in urine (MD:6.28 ng/mg creatinine, 95%CI: 4.01, 8.56) and in blood samples (MD:0.36 ng/ml, 95%CI: 0.04, 0.69). Interestingly, 8-OHdG levels progressively increased for increasing New York Heart Association (NYHA) class. Meta-regression models showed that none of clinical and demographic variables impacted on the difference in 8-OHdG levels among HF patients and controls.
  
  
  CONCLUSIONS
  8-OHdG levels are higher in HF patients HF than in controls, with a progressive increase for increasing NYHA class. However, larger prospective studies are needed to test 8-OHdG as a biomarker of HF severity and progression.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy. Electronic address: alessandro.diminno@ccfm.it.
authors.forename: A
authors.initials: A
authors.lastname: Di Minno
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Turnu
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Porro
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Squellerio
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy; Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20138 Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Cavalca
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy; Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20138 Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Tremoli
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University, Naples, Italy.
authors.forename: M N D
authors.initials: MN
authors.lastname: Di Minno
mesh_terms: D000080242:8-Hydroxy-2'-Deoxyguanosine; D015415:Biomarkers / Q000378:metabolism; D016009:Chi-Square Distribution; D004249:DNA Damage; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000378:metabolism; D006333:Heart Failure / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D009206:Myocardium / Q000378:metabolism*; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine
keywords: 8-OHdG; Heart failure; Meta-analysis; Oxidative stress