Malondialdehyde and Uric Acid as Predictors of Adverse Outcome in Patients with Chronic Heart Failure

Author:

Romuk Ewa1ORCID,Wojciechowska Celina2ORCID,Jacheć Wojciech2ORCID,Zemła-Woszek Aleksandra1ORCID,Momot Alina3ORCID,Buczkowska Marta4ORCID,Rozentryt Piotr45

Affiliation:

1. Department of Biochemistry, School of Medicine with the Division of Dentistry, Medical University of Silesia, Jordana 19 Street, 41-808 Zabrze, Poland

2. Second Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, M. C. Skłodowskiej 10 Street, 41-800 Zabrze, Poland

3. Institute of Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland

4. Department of Toxicology and Health Protection, School of Public Health, Medical University of Silesia, 41-902 Bytom, Poland

5. 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Silesian Centre for Heart Disease, 41-800 Zabrze, Poland

Abstract

In chronic heart failure (HF), some parameters of oxidative stress are correlated with disease severity. The aim of this study was to evaluate the importance of oxidative stress biomarkers in prognostic risk stratification (death and combined endpoint: heart transplantation or death). In 774 patients, aged 48-59 years, with chronic HF with reduced ejection fraction (median: 24.0 (20-29)%), parameters such as total antioxidant capacity, total oxidant status, oxidative stress index, and concentration of uric acid (UA), bilirubin, protein sulfhydryl groups (PSH), and malondialdehyde (MDA) were measured. The parameters were assessed as predictive biomarkers of mortality and combined endpoint in a 1-year follow-up. The multivariate Cox regression analysis was adjusted for other important clinical and laboratory prognostic markers. Among all the oxidative stress markers examined in multivariate analysis, only MDA and UA were found to be independent predictors of death and combined endpoint. Higher serum MDA concentration increased the risk of death by 103.0% (HR=2.103; 95% CI (1.330-3.325)) and of combined endpoint occurrence by 100% (HR=2.000; 95% CI (1.366-2.928)) per μmol/L. Baseline levels of MDA in the 4th quartile were associated with an increased risk of death with a relative risk (RR) of 3.64 (95% CI (1.917 to 6.926), p<0.001) and RR of 2.71 (95% CI (1.551 to 4.739), p<0.001) for the occurrence of combined endpoint as compared to levels of MDA in the 1st quartile. Higher serum UA concentration increased the risk of death by 2.1% (HR=1.021; 95% CI (1.005-1.038), p<0.001) and increased combined endpoint occurrence by 1.4% (HR=1.014; 95% CI (1.005-1.028), p<0.001), for every 10 μmol/L. Baseline levels of UA in the 4th quartile were associated with an increased risk for death with a RR of 3.21 (95% CI (1.734 to 5.931)) and RR of 2.73 (95% CI (1.560 to 4.766)) for the occurrence of combined endpoint as compared to the levels of UA in the 1st quartile. In patients with chronic HF, increased MDA and UA concentrations were independently related to poor prognosis in a 1-year follow-up.

Funder

Slaski Uniwersytet Medyczny

Publisher

Hindawi Limited

Subject

Cell Biology,Aging,General Medicine,Biochemistry

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