Urinary 8-Hydroxy-2'-Deoxyguanosine as a Novel Biomarker for Predicting Cardiac Events and Evaluating the Effectiveness of Carvedilol Treatment in Patients With Chronic Systolic Heart Failure

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Author(s)

    • SUSA Takehisa
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • KOBAYASHI Shigeki
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • TANAKA Takeo
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • MURAKAMI Wakako
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • AKASHI Shintaro
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • KUNITSUGU Ichiro
    • Department of Public Health, Yamaguchi University Graduate School of Medicine
    • OKUDA Shinichi
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • DOI Masahiro
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • WADA Yasuaki
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • NAO Tomoko
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • YAMADA Jutaro
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • UEYAMA Takeshi
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • OKAMURA Takayuki
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • YANO Masafumi
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • MATSUZAKI Masunori
    • Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine

Abstract

<b><i>Background:</i></b> The authors recently reported that urinary 8-hydroxy-2'-deoxyguanosine (U8-OHdG) derived from cardiac tissue reflects clinical status and cardiac dysfunction severity in patients with chronic heart failure (CHF). The aim of the present study was to investigate whether U8-OHdG levels can accurately predict cardiac events in CHF patients and their response to β-blocker treatment. <b><i>Methods and Results:</i></b> Plasma brain natriuretic peptide (BNP) and U8-OHdG levels were measured in 186 consecutive CHF patients before discharge. Patients were then prospectively followed (median follow-up, 649 days) with endpoints of cardiac death or hospitalization due to progressive heart failure. From receiver operating characteristic curve analysis, cut-offs were 12.4ng/mg creatinine (Cr) for U8-OHdG and 207pg/ml for BNP. On multivariate Cox analysis, U8-OHdG and BNP were independent predictors of cardiac events. Patients were classified into 4 groups according to U8-OHdG and BNP cut-offs. The hazard ratio for cardiac events in patients with BNP ≥207pg/ml and U8-OHdG ≥12.4ng/mg Cr was 16.2 compared with approximately 4 for patients with only 1 indicator above its respective cut-off. Furthermore, carvedilol therapy was initiated in 30 CHF patients. In responders (≥10% increase in left ventricular ejection fraction [LVEF] or ≥1 class decrease in New York Heart Association [NYHA] class), U8-OHdG levels decreased significantly along with improved NYHA class, LVEF, and BNP levels after treatment. <b><i>Conclusions:</i></b> U8-OHdG may be a useful biomarker for predicting cardiac events and evaluating β-blocker therapy effectiveness in CHF patients. (<i>Circ J</i> 2012; <b>76:</b> 117-126)<br>

Journal

  • Circulation Journal

    Circulation Journal 76(1), 117-126, 2011-12-25

    The Japanese Circulation Society

References:  39

Cited by:  2

Codes

  • NII Article ID (NAID)
    10030034360
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    13469843
  • Data Source
    CJP  CJPref  J-STAGE 
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