Circulating annexin A5 predicts mortality in patients with heart failure

• Published in: Journal of internal medicine 2016-01, Vol.279 (1), p.89-97
• Main Authors: Schurgers, L. J., Burgmaier, M., Ueland, T., Schutters, K., Aakhus, S., Hofstra, L., Gullestad, L., Aukrust, P., Hellmich, M., Narula, J., Reutelingsperger, C. P.
• Format: Article
• Language: English
• Subjects: Animals; annexin A5; Annexin A5 - blood; apoptosis; biomarkers; Biomarkers - blood; C-Reactive Protein - analysis; Female; Forecasting; Glomerular Filtration Rate; heart; heart failure; Heart Failure - mortality; Humans; Male; Mice; Mice, Inbred C57BL; Middle Aged; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Prospective Studies; Regression Analysis
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1111/joim.12396

Background Natriuretic peptides are currently used to predict mortality in patients with heart failure (HF). However, novel independent biomarkers are needed to improve risk stratification in these patients. We hypothesized that annexin A5 (anxA5) would be highly expressed by organs which are generally affected by HF and that circulating anxA5 levels would predict mortality in HF patients. Methods We prospectively determined the diagnostic value of anxA5, N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), C‐reactive protein (CRP) and estimated glomerular filtration rate (eGFR) to predict mortality in 180 HF patients during a median follow‐up of 3.6 years. Studies were conducted with anxA5−/− mice to investigate the underlying mechanisms. Results AnxA5 levels were significantly elevated in HF patients compared to healthy control subjects. Cox regression analysis demonstrated that anxA5, NT‐proBNP and eGFR all predict mortality independently. AnxA5 significantly improved the diagnostic efficiency of NT‐proBNP alone (improvement of c‐statistic from 0.662 to 0.705, P