Open Access Original investigation

Predictive value of advanced glycation end products for the development of post-infarction heart failure: a preliminary report

Sergio Raposeiras-Roubín1,2†, Bruno K Rodiño-Janeiro2†, Beatriz Paradela-Dobarro2, Lilian Grigorian-Shamagian3, José M García-Acuña1, Pablo Aguiar-Souto1, Michel Jacquet-Hervet1, María V Reino-Maceiras1, Ezequiel Álvarez2,4* and José R González-Juanatey1,2,4

Author Affiliations

1 Servicio de Cardiología. Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain

2 Instituto de Investigación Sanitaria Santiago de Compostela, Santiago de Compostela, Spain

3 Servicio de Cardiología. Hospital Meixoeiro, Vigo, Spain

4 Departamento de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, Spain

For all author emails, please log on.

Cardiovascular Diabetology 2012, 11:102 doi:10.1186/1475-2840-11-102

Published: 21 August 2012

Abstract

Background

Since post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development.

Methods

A prospective clinical study in patients after first acute coronary syndrome was conducted. The follow-up period was consisted in 1 year. In 194 patients consecutively admitted in the coronary unit for myocardial infarct fluorescent AGE levels were measured. The association between glycaemic parameters and the development of post-infarction HF were analyzed in those patients. Finally, we identified the variables with independent predictor value by performing a multivariate analysis of Hazard ratio for Cox regression.

Results

Eleven out of 194 patients (5.6%) developed HF during follow-up (median: 1.0 years [0.8 - 1.5 years]). Even though basal glucose, fructosamine and glycated haemoglobin were significant predictive factors in the univariate analysis, after being adjusted by confounding variables and AGE they lost their statistical signification. Only AGE (Hazard Ratio 1.016, IC 95%: 1.006-1.026; p<0,001), together with NT-proBNP and the infarct extension were predictors for post-infarction HF development, where AGE levels over the median value 5-fold increased the risk of HF development during follow-up.

Conclusions

AGE are an independent marker of post-infarction HF development risk.

Keywords:
Advanced glycation end products; Heart failure; Myocardial infarct; Ventricular remodelling; Diabetes mellitus