Comparison of soluble glycoprotein 130 and cardiac natriuretic peptides as long-term predictors of heart failure progression

Background: In patients with heart failure, B-type natriuretic peptides (BNP, N-BNP) and atrial natriuretic peptide (ANP) are established prognostic markers. However, circulating interleukin (IL)-6-related cytokines and soluble glycoprotein 130 (sgp130), their common subunit for signal transduction, are also increased. We hypothesized that levels. of circulating sgp130 and cardiac peptides provide independent prediction of worsening pump failure in the long term. Methods: A series of 76 patients (77% mate, 54 ischemic and 17 nonischemic, left ventricular ejection fraction 22% +/- 7%) had blood samples drawn for assay of sgp130, oncostatin-M, N-ANP, N-BNP, and BNP. A composite end point of worsening pump failure (requiring hospitalization, intravenous therapy, or urgent heart transplantation) and pump failure death was used for follow-up. Results: During follow-up (up to 7 years), rate of worsening pump failure was 22.3%, including death. N-ANP (5666 +/- 3100 vs 7850 +/- 12164 fmol/ml), N-BNP (278 +/- 284 vs 250 +/- 297 pmol/ml), and oncostatin-M (15 +/- 28 vs; 16 +/- 63 pg/ml) were similar in those who incurred worsening pump failure and in others. Mean sgp130 levels were 389 +/- 123 ng/ml in patients who developed worsening heart failure (Group A) and 289 +/- 123 ng/ml in stable patients (Group B; p < 0.0001). Mean BNP was 567 +/- 774 pg/ml in Group A and 307 +/- 324 pg/ml in Group B (p < 0.05). By using a cutoff value of 286 ng/ml for gp130 in Kaplan-Meier analysis, we found that the rate of freedom from worsening heart failure was significantly higher in patients below compared with patients above this cutoff point (p = 0.03). In univariate and multivariate Cox regression analysis, only sgp130 emerged as statistically significant (p < 0.001). Conclusions: In addition to BNP, sgp130 could be useful in identifying patients at high risk for heart failure progression.