Complement C3a predicts outcome in cardiac resynchronization therapy of heart failure

G. Széplaki, András Mihály Boros, Szabolcs Szilágyi, István Osztheimer, Zsigmond Jenei, Annamária Kosztin, Klaudia Vivien Nagy, Júlia Karády, Levente Molnár, Tamás Tahin, E. Zima, L. Gellér, Z. Prohászka, B. Merkely

Research output: Contribution to journalArticle

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Abstract

Background: The chronic inflammation plays an important role in heart failure and complement components might be useful markers of the prognosis. We set out to evaluate their predictive value in the clinical outcomes of patients with cardiac resynchronization therapy (CRT). Methods: We determined the complement levels C3, C3a, sC5b-9 and also the N-terminus of the prohormone brain natriuretic peptide (NT-proBNP) of 126 heart failure patients in a prospective, single-center observational study before and 6 months after CRT implantation. Results: CRT reduced the C3a [212.5 (148.2–283.6) vs. 153 (119.8–218.3) ng/mL, p < 0.0001] and the sC5b-9 levels [296.9 (234.2–358.8) vs. 255.1 (210.1–319.0) ng/mL, p = 0.0006], but not the total C3 levels [1.43 (1.26–1.61) vs. 1.38 (1.23–1.57) g/L, p = 0.57]. C3a predicted the 5-year mortality of the patients [C3a > 165 ng/mL hazard ratio = 4.21 (1.65–10.72), p = 0.003] independent of the NT-proBNP and other factors. After reclassification, we observed a significant net reclassification improvement [NRI = 0.71 (0.43–0.98), p < 0.0001] and integrated discrimination improvement [IDI = 0.08 (0.03–0.12), p = 0.0002]. Conclusions: In patients with CRT, elevated C3a levels increase the risk of mortality independent of the NT-proBNP levels or other factors. CRT exerts anti-inflammatory effect by reducing the complement activation.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalInflammation Research
DOIs
Publication statusAccepted/In press - Aug 4 2016

Fingerprint

Complement C3a
Cardiac Resynchronization Therapy
Heart Failure
Brain Natriuretic Peptide
Complement C3
Complement Activation
Observational Studies
Anti-Inflammatory Agents
Inflammation
Mortality

Keywords

  • C3a
  • CRT
  • Reverse remodeling
  • sC5b-9
  • Survival

ASJC Scopus subject areas

  • Immunology
  • Pharmacology

Cite this

Complement C3a predicts outcome in cardiac resynchronization therapy of heart failure. / Széplaki, G.; Boros, András Mihály; Szilágyi, Szabolcs; Osztheimer, István; Jenei, Zsigmond; Kosztin, Annamária; Nagy, Klaudia Vivien; Karády, Júlia; Molnár, Levente; Tahin, Tamás; Zima, E.; Gellér, L.; Prohászka, Z.; Merkely, B.

In: Inflammation Research, 04.08.2016, p. 1-8.

Research output: Contribution to journalArticle

Széplaki, G. ; Boros, András Mihály ; Szilágyi, Szabolcs ; Osztheimer, István ; Jenei, Zsigmond ; Kosztin, Annamária ; Nagy, Klaudia Vivien ; Karády, Júlia ; Molnár, Levente ; Tahin, Tamás ; Zima, E. ; Gellér, L. ; Prohászka, Z. ; Merkely, B. / Complement C3a predicts outcome in cardiac resynchronization therapy of heart failure. In: Inflammation Research. 2016 ; pp. 1-8.
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AU - Széplaki, G.

AU - Boros, András Mihály

AU - Szilágyi, Szabolcs

AU - Osztheimer, István

AU - Jenei, Zsigmond

AU - Kosztin, Annamária

AU - Nagy, Klaudia Vivien

AU - Karády, Júlia

AU - Molnár, Levente

AU - Tahin, Tamás

AU - Zima, E.

AU - Gellér, L.

AU - Prohászka, Z.

AU - Merkely, B.

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N2 - Background: The chronic inflammation plays an important role in heart failure and complement components might be useful markers of the prognosis. We set out to evaluate their predictive value in the clinical outcomes of patients with cardiac resynchronization therapy (CRT). Methods: We determined the complement levels C3, C3a, sC5b-9 and also the N-terminus of the prohormone brain natriuretic peptide (NT-proBNP) of 126 heart failure patients in a prospective, single-center observational study before and 6 months after CRT implantation. Results: CRT reduced the C3a [212.5 (148.2–283.6) vs. 153 (119.8–218.3) ng/mL, p < 0.0001] and the sC5b-9 levels [296.9 (234.2–358.8) vs. 255.1 (210.1–319.0) ng/mL, p = 0.0006], but not the total C3 levels [1.43 (1.26–1.61) vs. 1.38 (1.23–1.57) g/L, p = 0.57]. C3a predicted the 5-year mortality of the patients [C3a > 165 ng/mL hazard ratio = 4.21 (1.65–10.72), p = 0.003] independent of the NT-proBNP and other factors. After reclassification, we observed a significant net reclassification improvement [NRI = 0.71 (0.43–0.98), p < 0.0001] and integrated discrimination improvement [IDI = 0.08 (0.03–0.12), p = 0.0002]. Conclusions: In patients with CRT, elevated C3a levels increase the risk of mortality independent of the NT-proBNP levels or other factors. CRT exerts anti-inflammatory effect by reducing the complement activation.

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