Author + information
- Shweta Motiwala,
- Anju Bhardwaj,
- Jackie Szymonifka,
- Arianna Belcher,
- Rory Weiner,
- Aaron Baggish,
- Hanna Gaggin and
- James Januzzi
Insulin-like growth factor binding protein 7 (IGFBP7) may be a marker for cardiovascular (CV) outcomes, prognosis, and remodeling in chronic heart failure (HF).
142 subjects with left ventricular systolic dysfunction (LVSD) were followed through 908 visits over 10 ± 3 months. Amount of time spent with IGFBP7 level ≤102.9 pg/mL (study median) and change from baseline to final value were considered across study visits, and used to assess risk for adverse CV events and echocardiographic parameters of LV remodeling.
Median IGFBP7 values at baseline and 3 months were higher in patients with CV events (96.1 vs. 74.7 pg/mL, p = 0.005; 109.9 vs. 76.7 pg/mL, p = 0.009). Baseline elevated IGFBP7 level was associated with high cumulative hazard (Figure) that was additive to baseline NT-proBNP (p <0.001); serial measurement at 3 months added prognostic value to baseline level (p = 0.009). Duration of time spent with IGFBP7 ≤102.9 pg/mL was associated with a lower rate of CV events (28.0% if always low vs. 61.3% if always high; p = 0.001) and independently predicted fewer CV events even adjusted for NT-proBNP (OR = 0.88; 95% confidence interval [Cl] = 0.81-0.96, p = 0.006). Increase in IGFBP7 predicted increase in LV volume (OR = 35.2; 95% Cl = 2.1-599.8, p = 0.01). Use of beta-blockers and loop diuretics reduced IGFBP7 level (both p <0.05).
In chronic HF due to LVSD, serial measurement of IGFBP7 provides independent prognostic information and may predict deleterious myocardial remodeling.
Oral Contributions South, Room 102
Saturday, March 09, 2013, 8:45 a.m.-9:00 a.m.
Session Title: Heart Failure Pathogenesis and Therapy
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 905-6
- 2013 American College of Cardiology Foundation