Serviço de Medicina Interna, Centro Hospitalar São João, Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto, Porto, Portugal.
J Cardiovasc Pharmacol. 2013 Aug;62(2):138-42. doi: 10.1097/FJC.0b013e3182949673.
Dipeptidyl peptidase IV (DPP IV) is a key enzyme in B-type natriuretic peptide processing. DPP IV was never studied in human heart failure (HF). We aimed to measure DPP IV concentration in acute HF and determine its association with mortality.
Patients hospitalized with acute HF were eligible. We excluded patients with acute coronary syndromes. A discharge blood sample was collected from all patients and they were followed for a 6-month period. Outcome was HF death. Patients were compared across DPP IV quartiles. A Cox regression analysis was used to assess the prognostic power of DPP IV. We studied 164 patients. Median age was 78 years, 48.8% were men, and 63 had type 2 diabetes and 59.1% had left ventricular systolic dysfunction. Quartiles of DPP IV were <215.2; ≥ 215.2 and <269.3; ≥ 269.3 and <348.6; and ≥ 348.6 ng/mL; groups were homogenous between them. Seventeen patients died. Patients with DPP IV in the last quartile had a hazard ratio of HF death up to 6 months of 2.89, 95% confidence interval, 1.11-7.46. Association was B-type natriuretic peptide independent.
Discharge DPP IV ≥ 348.6 ng/mL conferred an approximately 3-fold higher risk of 6-month HF death. Further studies would be important to understand the role of DPP IV in HF.
二肽基肽酶 4（DPP IV）是 B 型利钠肽加工的关键酶。DPP IV 在人类心力衰竭（HF）中从未被研究过。我们旨在测量急性 HF 中的 DPP IV 浓度，并确定其与死亡率的关系。
符合条件的患者为因急性 HF 住院的患者。我们排除了急性冠状动脉综合征患者。所有患者均采集出院时的血样，并随访 6 个月。结果为 HF 死亡。根据 DPP IV 四分位数将患者进行比较。使用 Cox 回归分析评估 DPP IV 的预后能力。我们研究了 164 名患者。中位年龄为 78 岁，48.8%为男性，63 名患者患有 2 型糖尿病，59.1%有左心室收缩功能障碍。DPP IV 的四分位数分别为<215.2；≥215.2 且<269.3；≥269.3 且<348.6；≥348.6ng/mL；各组之间具有同质性。17 名患者死亡。DPP IV 处于最后一个四分位的患者在 6 个月内发生 HF 死亡的风险比高达 2.89，95%置信区间为 1.11-7.46。这种关联与 B 型利钠肽无关。
出院时 DPP IV≥348.6ng/mL 导致 6 个月 HF 死亡的风险增加约 3 倍。进一步的研究对于了解 DPP IV 在 HF 中的作用很重要。
