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Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure

(1) Background: Acute heart failure (HF) represents a complex clinical syndrome burdened by increased mortality and a high rate of systemic complications. Although natriuretic peptides (e.g., NT-proBNP) currently represent the diagnostic and prognostic gold standard in acute HF, those molecules do n...

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Autores principales: Miftode, Radu-Stefan, Costache, Irina-Iuliana, Constantinescu, Daniela, Mitu, Ovidiu, Timpau, Amalia-Stefana, Hancianu, Monica, Leca, Daniela-Anicuta, Miftode, Ionela-Larisa, Jigoranu, Raul-Alexandru, Oancea, Alexandru-Florinel, Haba, Mihai Stefan Cristian, Miftode, Diandra Ioana, Serban, Ionela-Lacramioara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146167/
https://www.ncbi.nlm.nih.gov/pubmed/37109427
http://dx.doi.org/10.3390/life13040898
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author Miftode, Radu-Stefan
Costache, Irina-Iuliana
Constantinescu, Daniela
Mitu, Ovidiu
Timpau, Amalia-Stefana
Hancianu, Monica
Leca, Daniela-Anicuta
Miftode, Ionela-Larisa
Jigoranu, Raul-Alexandru
Oancea, Alexandru-Florinel
Haba, Mihai Stefan Cristian
Miftode, Diandra Ioana
Serban, Ionela-Lacramioara
author_facet Miftode, Radu-Stefan
Costache, Irina-Iuliana
Constantinescu, Daniela
Mitu, Ovidiu
Timpau, Amalia-Stefana
Hancianu, Monica
Leca, Daniela-Anicuta
Miftode, Ionela-Larisa
Jigoranu, Raul-Alexandru
Oancea, Alexandru-Florinel
Haba, Mihai Stefan Cristian
Miftode, Diandra Ioana
Serban, Ionela-Lacramioara
author_sort Miftode, Radu-Stefan
collection PubMed
description (1) Background: Acute heart failure (HF) represents a complex clinical syndrome burdened by increased mortality and a high rate of systemic complications. Although natriuretic peptides (e.g., NT-proBNP) currently represent the diagnostic and prognostic gold standard in acute HF, those molecules do not accurately reflect all the pathophysiological mechanisms involved in the progression of this pathology when determined independently. Therefore, the current paradigm tends to focus on a multi-marker approach for the risk stratification of patients with acute HF. Syndecan-1 is a less studied biomarker in cardiovascular diseases; its assessment in patients with acute HF being potentially able to reflect the myocardial pathological changes, such as fibrosis, inflammation, endothelial dysfunction or global wall stress. (2) Methods: We conducted a single center prospective study that enrolled 173 patients (120 patients admitted for acute HF, compared to 53 controls with stable chronic HF). A complete standardized clinical, echocardiography and laboratory evaluation was performed at admission, including serum samples for the determination of syndecan-1 by the enzyme-linked immunosorbent assay (ELISA) method. (3) Results: The serum concentration of syndecan-1 was significantly higher in patients with acute HF, compared to controls [121.4 (69.3–257.9) vs. 72.1 (41.4–135.8) ng/mL, p = 0.015]. Syndecan-1 was a significant predictor for the diagnosis of acute HF, expressed by an area under the curve (AUC) of 0.898, similar to NT-proBNP (AUC: 0.976) or cardiac troponin (AUC: 0.839). Moreover, syndecan-1 was independently associated with impaired kidney and liver function at admission, being also a predictor for early, subclinical organ dysfunction in patients with normal biological parameters at admission. When included in the multi-marker model, syndecan-1 levels influenced mortality more significantly than NT-proBNP or troponin. A multivariable regression including syndecan-1, NT-proBNP and troponin provided additional prognostic value compared to each independent biomarker. (4) Conclusions: Syndecan-1 can be considered a promising novel biomarker in acute HF, exhibiting adequate diagnostic and prognostic value. Additionally, syndecan-1 can be used as a surrogate biomarker for non-cardiac organ dysfunction, as its highs levels can accurately reflect early acute kidney and liver injury.
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spelling pubmed-101461672023-04-29 Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure Miftode, Radu-Stefan Costache, Irina-Iuliana Constantinescu, Daniela Mitu, Ovidiu Timpau, Amalia-Stefana Hancianu, Monica Leca, Daniela-Anicuta Miftode, Ionela-Larisa Jigoranu, Raul-Alexandru Oancea, Alexandru-Florinel Haba, Mihai Stefan Cristian Miftode, Diandra Ioana Serban, Ionela-Lacramioara Life (Basel) Article (1) Background: Acute heart failure (HF) represents a complex clinical syndrome burdened by increased mortality and a high rate of systemic complications. Although natriuretic peptides (e.g., NT-proBNP) currently represent the diagnostic and prognostic gold standard in acute HF, those molecules do not accurately reflect all the pathophysiological mechanisms involved in the progression of this pathology when determined independently. Therefore, the current paradigm tends to focus on a multi-marker approach for the risk stratification of patients with acute HF. Syndecan-1 is a less studied biomarker in cardiovascular diseases; its assessment in patients with acute HF being potentially able to reflect the myocardial pathological changes, such as fibrosis, inflammation, endothelial dysfunction or global wall stress. (2) Methods: We conducted a single center prospective study that enrolled 173 patients (120 patients admitted for acute HF, compared to 53 controls with stable chronic HF). A complete standardized clinical, echocardiography and laboratory evaluation was performed at admission, including serum samples for the determination of syndecan-1 by the enzyme-linked immunosorbent assay (ELISA) method. (3) Results: The serum concentration of syndecan-1 was significantly higher in patients with acute HF, compared to controls [121.4 (69.3–257.9) vs. 72.1 (41.4–135.8) ng/mL, p = 0.015]. Syndecan-1 was a significant predictor for the diagnosis of acute HF, expressed by an area under the curve (AUC) of 0.898, similar to NT-proBNP (AUC: 0.976) or cardiac troponin (AUC: 0.839). Moreover, syndecan-1 was independently associated with impaired kidney and liver function at admission, being also a predictor for early, subclinical organ dysfunction in patients with normal biological parameters at admission. When included in the multi-marker model, syndecan-1 levels influenced mortality more significantly than NT-proBNP or troponin. A multivariable regression including syndecan-1, NT-proBNP and troponin provided additional prognostic value compared to each independent biomarker. (4) Conclusions: Syndecan-1 can be considered a promising novel biomarker in acute HF, exhibiting adequate diagnostic and prognostic value. Additionally, syndecan-1 can be used as a surrogate biomarker for non-cardiac organ dysfunction, as its highs levels can accurately reflect early acute kidney and liver injury. MDPI 2023-03-28 /pmc/articles/PMC10146167/ /pubmed/37109427 http://dx.doi.org/10.3390/life13040898 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Miftode, Radu-Stefan
Costache, Irina-Iuliana
Constantinescu, Daniela
Mitu, Ovidiu
Timpau, Amalia-Stefana
Hancianu, Monica
Leca, Daniela-Anicuta
Miftode, Ionela-Larisa
Jigoranu, Raul-Alexandru
Oancea, Alexandru-Florinel
Haba, Mihai Stefan Cristian
Miftode, Diandra Ioana
Serban, Ionela-Lacramioara
Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure
title Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure
title_full Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure
title_fullStr Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure
title_full_unstemmed Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure
title_short Syndecan-1: From a Promising Novel Cardiac Biomarker to a Surrogate Early Predictor of Kidney and Liver Injury in Patients with Acute Heart Failure
title_sort syndecan-1: from a promising novel cardiac biomarker to a surrogate early predictor of kidney and liver injury in patients with acute heart failure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146167/
https://www.ncbi.nlm.nih.gov/pubmed/37109427
http://dx.doi.org/10.3390/life13040898
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