AUTHOR=Agra-Bermejo Rosa M. , Cacho-Antonio Carla , Gonzalez-Babarro Eva , Rozados-Luis Adriana , Couselo-Seijas Marinela , Gómez-Otero Inés , Varela-Román Alfonso , López-Canoa José N , Gómez-Rodríguez Isabel , Pata María , Eiras Sonia , González-Juanatey Jose R.
TITLE=A New Biomarker Tool for Risk Stratification in “de novo” Acute Heart Failure (OROME)
JOURNAL=Frontiers in Physiology
VOLUME=12
YEAR=2022
URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2021.736245
DOI=10.3389/fphys.2021.736245
ISSN=1664-042X
ABSTRACT=Background: Inflammation is one of the mechanisms involved in heart failure (HF) pathophysiology. Thus, the acute phase reactant protein, orosomucoid, was associated with a worse post-discharge prognosis in de novo acute HF (AHF). However, the presence of anti-inflammatory adipokine, omentin, might protect and reduce the severity of the disease. We wanted to evaluate the value of omentin and orosomucoid combination for stratifying the risk of these patients.
Methods and Results: Two independent cohorts of patients admitted for de novo AHF in two centers were included in the study (n = 218). Orosomucoid and omentin circulating levels were determined by ELISA at discharge. Patients were followed-up for 317 (3–575) days. A predictive model was determined for the primary endpoint, death, and/or HF readmission. Differences in survival were evaluated using a Log-rank test. According to cut-off values of orosomucoid and omentin, patients were classified as UpDown (high orosomucoid and low omentin levels), equal (both proteins high or low), and DownUp (low orosomucoid and high omentin levels). The Kaplan Meier determined a worse prognosis for the UpDown group (Long-rank test p = 0.02). The predictive model that includes the combination of orosomucoid and omentin groups (OROME) + NT-proBNP values achieved a higher C-index = 0.84 than the predictive model with NT-proBNP (C-index = 0.80) or OROME (C-index = 0.79) or orosomucoid alone (C-index = 0.80).
Conclusion: The orosomucoid and omentin determination stratifies de novo AHF patients into the high, mild, and low risk of rehospitalization and/or death for HF. Its combination with NT-proBNP improves its predictive value in this group of patients.