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The subset of patients with acute heart failure able to secrete relaxin-2 at pregnancy concentrations could have a longer survival: a pilot study

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posted on 2018-07-03, 08:29 authored by Òscar Miró, Pablo Herrero-Puente, Belén Prieto, María García-García, Pablo García-Hernández, Francisco J. Martín-Sánchez, Javier Jacob, José Ríos, Rodolfo Romero, Víctor Gil, Étienne Gayat, Pere Llorens, Alexandre Mebazaa

Objective: To investigate how many patients with acute heart failure (AHF) hypersecrete relaxin-2 concentrations similar to those of pregnant women and determine their long-term outcome.

Methods: In consecutive AHF patients relaxin-2 was quantified by ELISA sandwich method. Patients were divided into pregnancy-like group (PLG, relaxin-2 ≥ 500 pg/mL) and control group (CG, relaxin-2 < 500 pg/mL). The primary outcome was all-cause death during follow-up. Secondary endpoints were prolonged hospitalisation (>10 days), combined endpoint (death, rehospitalisation, ED revisit) 30 days after discharge, and 30-day, one-year and three-year death rates.

Results: We included 814 patients [81 (SD = 9) years; 53.0% women] followed during 1.9 (SD 2.8) years; 517 (63.5%) died. Twenty patients (2.5%) formed the PLG (median relaxin-2 = 1459 pg/mL; IQR = 1722) and 794 the CG (median = 26; IQR = 44). There was no interaction with variables included on adjustment (age, sex, ischaemic cardiomyopathy, NT-proBNP, glycaemia, and sodium). PLG patients did not have better short-term secondary endpoints, but did show a significantly lower three-year mortality [ORadjusted = 0.17 (0.05–0.5), p = 0.003].

Conclusions: The small proportion of AHF patients achieving relaxin-2 concentrations similar to those observed in pregnancy may survive longer.

Funding

This study was partially supported by competitive grants from the Instituto de Salud Carlos III supported with funds from the Spanish Ministry of Health and FEDER (PI10/01918, PI11/01021, PI15/01019 and PI15/00773), Catalonia Government (SGR 2009/1385 and 2014/0313), and Fundació La Marató de TV3 (2015/2510), and by a non-competitive grant from Novartis España. The design, experiments, data analysis, discussion and final conclusions were exclusively carried out by the authors without no participation of the granters.

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