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GlycA and GlycB as Inflammatory Markers in Chronic Heart Failure

  • German Cediel
    Affiliations
    Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain

    Center for Biomedical Research on Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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  • Albert Teis
    Affiliations
    Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain

    Center for Biomedical Research on Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain

    Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
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  • Pau Codina
    Affiliations
    Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
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  • Josep Julve
    Affiliations
    Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

    Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
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  • Mar Domingo
    Affiliations
    Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
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  • Evelyn Santiago-Vacas
    Affiliations
    Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain

    Center for Biomedical Research on Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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  • Esmeralda Castelblanco
    Affiliations
    Department of Internal Medicine, Endocrinology, Metabolism and Lipid Research Division, Washington University School of Medicine, St Louis, Missouri

    Unitat de Suport a la Recerca Barcelona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAP Jordi Gol), Barcelona, Spain
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  • Nuria Amigó
    Affiliations
    Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

    Departamento de Ciencias Médicas Básicas, Universidad Rovira i Virgili, Tarragona, Spain

    Biosfer Teslab – Metabolomic Platform, Universidad Rovira i Virgili, Tarragona, Spain
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  • Josep Lupón
    Affiliations
    Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain

    Center for Biomedical Research on Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain

    Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
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  • Didac Mauricio
    Affiliations
    Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

    Unitat de Suport a la Recerca Barcelona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAP Jordi Gol), Barcelona, Spain

    Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain

    Faculty of Medicine, University of Vic (UVIC), Vic, Spain
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  • Nuria Alonso
    Correspondence
    Corresponding author.
    Affiliations
    Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

    Department of Endocrinology & Nutrition, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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  • Antoni Bayés-Genís
    Correspondence
    Corresponding author.
    Affiliations
    Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias I Pujol, Badalona, Spain

    Center for Biomedical Research on Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain

    Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
    Search for articles by this author
      The role of inflammation in heart failure (HF) has been extensively described, but it is uncertain whether inflammation exerts a different prognostic influence according to etiology. We aimed to examine the inflammatory state in chronic HF by measuring N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB), evolving proton nuclear magnetic resonance biomarkers of systemic inflammation, and explore their prognostic value in patients with chronic HF. The primary end point was a composite of all-cause death and HF readmission. A total of 429 patients were included. GlycB correlated with interleukin-1 receptor-like 1 in the whole cohort (r2 = 0.14, p = 0.011) and the subgroup of nonischemic etiology (r2 = 0.31, p <0.001). No association was found with New York Heart Association functional class or left ventricular ejection fraction. In patients with nonischemic HF (52.2%, n = 224), GlycA and GlycB exhibited significant association with the composite end point (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.06 to 1.33, p = 0.004 and HR 2.13, 95% CI 1.43 to 3.13, p <0.001; respectively) and GlycB with HF readmission after multivariable adjustment (HR 2.25, 95% CI 1.54 to 3.30, p <0.001). GlycB levels were also associated with a greater risk of HF-related recurrent admissions (adjusted incidence rate ratio 1.33, 95% CI = 1.07 to 1.65, p = 0.009). None of the markers were associated with the clinical end points in patients with ischemic HF. In conclusion, GlycA and GlycB represent an evolving approach to inflammation status with prognostic value in long-term outcomes in patients with nonischemic HF.
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