Insulin-like Growth Factor Binding Protein 2 predicts mortality risk in heart failure. (1st February 2020)

• Record Type: Journal Article
• Authors: Barutaut, Manon; Fournier, Pauline; Peacock, William F.; Evaristi, Maria Francesca; Caubère, Céline; Turkieh, Annie; Desmoulin, Franck; Eurlings, Luc W.M.; van Wijk, Sandra; Rocca, Hans-Peter Brunner-La; Butler, Javed; Koukoui, François; Dambrin, Camille; Mazeres, Serge; Le Page, Servane; Delmas, Clement; Galinier, Michel; Jung, Christian; Smih, Fatima; Rouet, Philippe
• Is Part Of: International journal of cardiology. Volume 300(2020)
• Page Start: 245
• Page End: 251
• Publication Date: 2020-02-01
• Subjects: BNP B-type natriuretic peptide -- CI confidence interval -- ED emergency department -- HF heart failure -- IBLOMAVED Identification of BLOod MArkers for Asymptomatic VEntricular Dysfunction -- IGF-1/IGF-2 insulin-like growth factor 1 or 2 -- IGFBP2 insulin-like growth factor binding protein 2 -- IQR interquartile range or interval -- LVEF left ventricular ejection fraction -- NT-proBNP N-terminal pro-B type natriuretic peptide -- NRI Net Reclassification Index -- IDI Integrated Discrimination Improvement; IGFBP2 -- Biomarker -- Heart failure -- Prognosis -- Natriuretic peptides -- Cardiovascular mortality; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2019.09.032
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Insulin-like Growth Factor Binding Protein 2 (IGFBP2) showed greater heart failure (HF) diagnostic accuracy than the "grey zone" B-type natriuretic peptides, and may have prognostic utility as well. Objectives: To determine if IGFBP2 provides independent information on cardiovascular mortality in HF. Methods: A retrospective study of 870 HF patients from 3 independent international cohorts. Presentation IGFBP2 plasma levels were measured by ELISA, and patients were followed from 1 year (Maastricht, Netherlands) to 6 years (Atlanta, GA, USA and Toulouse, France). Multivariate analysis, Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) were performed in the 3 cohorts. The primary outcome was cardiovascular mortality. Results: In multivariate Cox proportional hazards analysis, the highest quartile of IGFBP2 was associated with mortality in the Maastricht cohort (adjusted hazard ratio 1.69 (95% CI, 1.18–2.41), p = 0.004) and in the combined Atlanta and Toulouse cohorts (adjusted hazard ratio 2.04 (95%CI, 1.3–3.3), p = 0.003). Adding IGFBP2 to a clinical model allowed a reclassification of adverse outcome risk in the Maastricht cohort (NRI = 18.7% p = 0.03; IDI = 3.9% p = 0.02) and with the Atlanta/Toulouse patients (NRI of 40.4% p = 0.01, 31, 2% p = 0.04, 31.5% p = 0, 02 and IDI of 2, 9% p = 0, 0005, 3.1% p = 0, 0005 and 4, 2%, p = 0.0005, for a follow-up of 1, 2 and 3 years, respectively). Conclusion: In 3 international cohorts, IGFBP2 level is a strong prognostic factor for cardiovascular mortality in HF, adding information to natriuretic monitoring and usual clinical markers, that should be further prospectively evaluated for patients' optimized care. Highlights: Heart failure (HF) current median survival rate is <5 years. Insulin-like Growth Factor Binding Protein 2 (IGFBP2) is a HF diagnostic biomarker. IGFBP2 has greater diagnostic accuracy than "grey zone" natriuretic peptides. IGFBP2 is a predictor for mortality in chronic and acute heart failure patients. IGFBP2 adds prognostic value to natriuretic peptides and clinical data.