The CirculatingVE-catherin as Predictor of Poor Outcomes in Patients with Ischemic Chronic Heart Failure

Aim: To evaluate the predictive value of circulating VE-catherin for cumulative cardiovascular outcomes in patients with chronic heart failure (CHF). Methods: A total of 388 patients with CHF were enrolled in the study on discharge from the hospital. Observation period was up to 3 years. Blood samples for biomarkers measurements were collected. ELISA method for measurements of circulating level of CD144 (VE-catherin) was used. Concentrations of VEcatherin for cumulative cardiovascular outcomes were tested. Results: Median follow-up was of 2.32 years (IQR=1.8-3.0). During followup, 110 cardiovascular events (including 43 fatal cases) were determined. Thirty five patients were died due to advance of CHF, and eight cases of death were related with suddenly death, fatal myocardial infarction, and systemic thromboembolism. Therefore, 74 subjects were readmitted in the hospital due to worsening CHF and 16 subjects were readmitted due to other cardiovascular reasons. Medians of circulating levels of VE-catherin in both patient cohorts (without and with experienced clinical outcomes) were 0.63 ng/mL (iterquartile range [IQR] = 0.55-0.64 ng/mL) and 1.03 ng/ml (IQR = 0.97-1.07 ng/mL) (P<0.001). Receive Operation Curve analysis has shown that the best balanced the cut-off of VE-catherin concentration for combined cardiovascular events was 0.755ng/ml. A significantly divergence of Kaplan-Meier curves in high VE-catherin patients (>0.755ng/ml) and low VE-catherin (<0.755 ng/ml) was reported. Multivariate age-adjusted Cox regression shown that NYHA class, VEcatherin, NT-pro-BNP and LVEF remained independent predictors for combined cardiovascular events, whereasT2DM and hs-CRP did not. Conclusion: We found that increased circulating VE-catherin associated with increased three-year combined cardiovascular events among patients with CHF. Adding VE-catherin level to NT-pro BNP and NYHA class sufficient improve the prediction of standard model of CHF.