Fetuin-A and sodium concentrations are independently associated with all-cause mortality in patients awaiting heart transplantation.

INTRODUCTION

End‑stage heart failure (HF) is a clinical condition with complex pathophysiology and poor prognosis.

OBJECTIVES

This study aimed to identify factors associated with mortality during a 1.5‑year follow‑up in patients with end‑stage HF.

PATIENTS AND METHODS

We prospectively analyzed 72 patients hospitalized with end‑stage HF. During right heart catheterization, 10 ml of coronary sinus (CS) blood was collected. The endpoint was all‑cause mortality during a 1.5‑yearfollow‑up. We used a multivariable logistic regression model to find  factors associated with all‑cause mortality. We created 2 separate models for CS fetuin and peripheral blood (PB) fetuin.

RESULTS

The median (interquartile range) age of the patients was 58 (50-61.50) years. During the follow‑up, 43.1% of the patients died. Lower levels of fetuin‑A in the CS (OR, 1.103; 95% CI, 1.045-1.164; P <0.001, per 10-unit decrease in fetuin concentration) and PB samples (OR, 1.098; 95% CI, 1.046-1.153; P <0.001, per 10-unit decrease in fetuin concentration), along with lower plasma sodium levels (OR, 1.563; 95% CI, 1.134-2.156; P = 0.006 in the first model and OR, 1.639; 95% CI, 1.209-2.227; P = 0.002 in the second model; per 1-unit decrease in sodium concentration) were independently associated with death during the follow‑up period. The area under the receiver operating characteristics curve (AUC) indicated a good prognostic power of CS and PB fetuin‑A levels (AUC, 0.917 and AUC, 0.850, respectively) and an acceptable prognostic power of sodium concentration (AUC, 0.788).

CONCLUSIONS

Lower levels of CS and PB fetuin‑A, as well as lower sodium levels, are associated with an increased risk of death in patients with end‑stage HF.