HGF strong predictor of mortality in HF patients
MedWire News: Austrian researchers have shown that hepatocyte growth factor (HGF) is a strong independent predictor of mortality in advanced, ischemic heart failure (HF) patients.
Alexander Niessner (Medical University of Vienna) and colleagues assessed the prognostic value of HGF in 351 patients with advanced systolic HF. They then compared its prognostic value between patients with ischemic and non-ischemic etiology of HF, and performed stratified analyses to evaluate the combined risk prediction by HGF and B-type natriuretic peptide (BNP) levels.
The study population had a median age of 75 years, and 66% were male. The primary and secondary endpoints were all-cause mortality and cardiovascular (CV) mortality, respectively.
As reported in the journal Heart, 26% of patients died during the 16-month follow-up. The researchers found that each rise in HGF tertile was associated with an increased risk for all-cause mortality (p<0.001), with a three-fold increased hazard for the third compared with the first tertile. After adjusting for B-type natriuretic peptide (BNP) and HF risk factors, this association remained significant (p=0.002).
Further analysis showed that HGF was a strong predictor of CV mortality in ischemic HF (p=0.009) with an adjusted six-fold increased risk in the third compared with first tertile. By contrast, it was not a strong predictor of CV mortality in non-ischemic HF.
Niessner et al then assessed survival in the combined strata of HGF and BNP to determine whether combining HGF and BNP had additive prognostic value. They found that high HGF indicates a poor prognosis even in patients with low BNP. This subgroup of patients had a comparable risk to those with elevated BMP, but low HGF. Crucially, the greatest risk was found when both factors were raised.
"This additive prognostic value of HGF may help to identify patients at high risk who would benefit from intensive treatment," the authors explain.
They believe that the strength of the association observed suggests that HGF plays an important role in the pathogenesis and progression of ischemic HF.
"The particularly strong predictive value of HGF for CV mortality further emphasizes its potential role in atherosclerotic disease…and could help to identify high-risk patients," Niessner et al conclude.
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By Piriya Mahendra