Complement Components sC5b-9 and CH50 Predict Prognosis in Heart Failure Patients Combined With Hypertension.
Am J Hypertens
; 33(1): 53-60, 2020 01 01.
Article
in En
| MEDLINE
| ID: mdl-31429866
BACKGROUND: Heart failure (HF), resulting from inflammation and vessel injury, is one of the leading causes of poor quality of life and premature death. The complement system plays a leading role in vessel integrity and inflammation response. However, the association between serum complement level and the prognosis of HF remains unclear. METHODS: In our study, a total of 263 newly diagnosed hypertension patients with HF were included. Eight classical cardiovascular risk factors were collected, and plasma C3a, C3b, C5a, sC5b-9, and CH50 levels were detected. RESULTS: Compared with the control group, plasma C5a (P<0.001), sC5b-9 (P<0.001), and CH50 (P = 0.004) levels of hypertension patients with HF were significantly increased. On the basis of univariate analysis, an older age, higher frequency of alcohol consumption, high level of body mass index, medium or high risk of hypertension, hyperlipidemia, and diabetes were poor prognostic factors whereas low levels of C5a, sC5b-9, and CH50 were associated with favorable overall survival (OS). When these factors fit into a multivariate regression model, patients with hyperlipidemia (P = 0.002, hazard ratio [HR] = 3.09), N-terminal pro-Brain Natriuretic Peptide (NT-pro-BNP) ≥ 14.8 (P < 0.001, HR = 11.14), sC5b-9 level ≥ 1,406.2 µg/ml (P = 0.180, HR = 5.51) or CH50 level ≥ 294.6 µg/ml (P < 0.001, HR = 4.57) remained statistically factors for worsened OS and regarded as independent risk factors. These independently associated risk factors were used to form an OS estimation nomogram. Nomogram demonstrated good accuracy in estimating the risk, with a bootstrap-corrected C index of 0.789. CONCLUSIONS: sC5b-9 and CH50 levels are increased in hypertension patients with HF. Nomogram based on multivariate analysis has good accuracy in estimating the risk of OS.
Key words
Full text:
1
Collection:
01-internacional
Health context:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Database:
MEDLINE
Main subject:
Complement Hemolytic Activity Assay
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Complement Membrane Attack Complex
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Nomograms
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Clinical Decision-Making
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Heart Failure
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Hypertension
/
Inflammation
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Am J Hypertens
Year:
2020
Document type:
Article