Annexin A1 is a Potential Novel Biomarker of Congestion in Acute Heart Failure.

Abstract

OBJECTIVES:

This study sought to identify the role of annexin A1 (AnxA1) as a congestion marker in acute heart failure (AHF) and to identify its putative role in predicting clinical outcomes.

BACKGROUND:

AnxA1 is a protein that inhibits inflammation following ischemia-reperfusion injury in cardiorenal tissues. Because AHF is a state of tissue hypoperfusion, we hypothesized that plasma AnxA1 levels are altered in AHF.

METHODS:

In the Renal Optimization Strategies Evaluation (ROSE) trial, patients hospitalized for AHF with kidney injury were randomized to receive dopamine, nesiritide, or placebo for 72 hours in addition to diuresis. In a subanalysis, plasma AnxA1 levels were measured at baseline and at 72 hours in 275 patients. Participants were divided into 3 tertiles based on their baseline AnxA1 levels.

RESULTS:

The prevalence of peripheral edema 2+ increased with increasing AnxA1 levels (P < .007). Cystatin C, blood urea nitrogen, and kidney injury molecule-1 plasma levels were higher among participants in tertile 3 vs tertiles 1 or 2 (P< .05). Patients with a congestion score of 4 had a mean baseline AnxA1 level 8.63 units higher than those with a congestion score of 0 (P = .03). Patients in tertiles 2 and 3 were twice as likely to experience creatinine elevation as patients in tertile 1 (P = .03). Patients in tertiles 2 and 3 were at a higher risk of 60-day all-cause mortality or heart failure hospitalization and 180-day all-cause mortality (P < .05).

CONCLUSIONS:

Among patients hospitalized for AHF with impaired kidney function, elevated AnxA1 levels are associated with worse congestion, higher risk for further creatinine elevation, and higher rates of 60-day morbidity or all-cause mortality and 180-day all-cause mortality.

CLINICAL TRIAL REGISTRATION:

clinicaltrials.gov Identifier: NCT01132846.

• Authors: Fadi W Adel, Aruna Rikhi, Siu-Hin Wan, Seethalakshmi R Iyer, Hrishikesh Chakraborty, Steven McNulty, W H Wilson Tang, G Michael Felker, Michael M Givertz, Horng H Chen
• Journal: Journal of cardiac failure (J Card Fail) Vol. 26 Issue 8 Pg. 727-732 (Aug 2020) ISSN: 1532-8414 [Electronic] United States
• PMID: 32473378 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Annexin A1
• Biomarkers
• Natriuretic Peptide, Brain

Topics

• Acute Disease
• Annexin A1
• Biomarkers
• Heart Failure (diagnosis, drug therapy, epidemiology)
• Humans
• Natriuretic Peptide, Brain
• Treatment Outcome