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dc.contributor.authorUeland, Thor
dc.contributor.authorGullestad, Lars
dc.contributor.authorKou, Lei
dc.contributor.authorAukrust, Pål
dc.contributor.authorAnand, Inder S.
dc.contributor.authorNordlund, Marianne Sparby
dc.contributor.authorMcMurray, John J.
dc.contributor.authorvan Veldhuisen, Dirk J.
dc.contributor.authorWarren, David
dc.contributor.authorBolstad, Nils
dc.date.accessioned2018-11-08T07:38:24Z
dc.date.available2018-11-08T07:38:24Z
dc.date.issued2018-08-25
dc.description.abstract<p><i>Aims</i>: Neuroendocrine activation is associated with poor outcome in heart failure (HF). The neuropeptide gastrin‐releasing peptide (GRP), derived from the precursor proGRP1‐125 (proGRP), has recently been implicated in inflammation and wound repair. We investigated the predictive value of proGRP on clinical outcomes in HF patients with reduced ejection fraction.</p> <p><i>Methods and results</i>: The association between plasma proGRP (time‐resolved immunofluorometric assay) and the primary endpoint of death from any cause or first hospitalization for worsening of HF was evaluated using multivariable Cox proportional hazard models in 1541 patients with systolic HF and mild to moderate anaemia, enrolled in the Reduction of Events by Darbepoetin alfa in Heart Failure (RED‐HF) trial. Median proGRP levels in the RED‐HF cohort were markedly increased [95 ng/L (25th, 75th percentile, 69–129 ng/L)] with 64% patients above the 80 ng/L reference limit. Baseline proGRP correlated with estimated glomerular filtration rate (r = 0.52), N terminal pro brain natriuretic peptide (r = 0.33), troponin T (r = 0.34), and haemoglobin (r = 0.16) (all P < 0.001). The incidence outcome increased with increasing tertiles of baseline proGRP (primary endpoint third tertile vs. the lowest tertile; hazard ratio 1.91; 95% confidence interval 1.60–2.28, P < 0.001). However, these associations were markedly attenuated and non‐significant in adjusted models. No interaction between baseline proGRP and the effect of darbepoetin alfa treatment was detected. Moreover, no significant association between changes in proGRP during 6 month follow‐up and outcome was observed.</p> <p><i>Conclusions</i>: Pro‐gastrin‐releasing peptide is increased in patients with HF with reduced ejection fraction and anaemia, in particular in patients with poor renal function. However, proGRP adds little as a prognostic marker on top of conventional HF risk factors.</p>en_US
dc.descriptionSource at <a href=https://doi.org/10.1002/ehf2.12312> https://doi.org/10.1002/ehf2.12312</a>.en_US
dc.identifier.citationUeland, T., Gullestad, L., Kou, L., Aukrust, P., Anand, I.S., Nordlund Broughton, M., ... Bolstad, N. (2018). Pro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF study. ESC Heart Failure. https://doi.org/10.1002/ehf2.12312en_US
dc.identifier.cristinIDFRIDAID 1607735
dc.identifier.doi10.1002/ehf2.12312
dc.identifier.issn2055-5822
dc.identifier.urihttps://hdl.handle.net/10037/14119
dc.language.isoengen_US
dc.publisherWiley Open Accessen_US
dc.relation.journalESC Heart Failure
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771en_US
dc.subjectProGRPen_US
dc.subjectAnaemiaen_US
dc.subjectHeart failureen_US
dc.subjectPrognosisen_US
dc.titlePro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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